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Busch HJ, Wolfrum S, Michels G, Baumgärtel M, Bodmann KF, Buerke M, Burst V, Enghard P, Ertl G, Fach WA, Hanses F, Heppner HJ, Hermes C, Janssens U, John S, Jung C, Karagiannidis C, Kiehl M, Kluge S, Koch A, Kochanek M, Korsten P, Lepper PM, Merkel M, Müller-Werdan U, Neukirchen M, Pfeil A, Riessen R, Rottbauer W, Schellong S, Scherg A, Sedding D, Singler K, Thieme M, Trautwein C, Willam C, Werdan K. [Clinical acute and emergency medicine curriculum-focus on internal medicine : Recommendations for advanced training in internal medicine in the emergency department]. Med Klin Intensivmed Notfmed 2024; 119:1-50. [PMID: 38625382 PMCID: PMC11098871 DOI: 10.1007/s00063-024-01113-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 04/17/2024]
Abstract
In Germany, physicians qualify for emergency medicine by combining a specialty medical training-e.g. internal medicine-with advanced training in emergency medicine according to the statutes of the State Chambers of Physicians largely based upon the Guideline Regulations on Specialty Training of the German Medical Association. Internal medicine and their associated subspecialities represent an important column of emergency medicine. For the internal medicine aspects of emergency medicine, this curriculum presents an overview of knowledge, skills (competence levels I-III) as well as behaviours and attitudes allowing for the best treatment of patients. These include general aspects (structure and process quality, primary diagnostics and therapy as well as indication for subsequent treatment; resuscitation room management; diagnostics and monitoring; general therapeutic measures; hygiene measures; and pharmacotherapy) and also specific aspects concerning angiology, endocrinology, diabetology and metabolism, gastroenterology, geriatric medicine, hematology and oncology, infectiology, cardiology, nephrology, palliative care, pneumology, rheumatology and toxicology. Publications focussing on contents of advanced training are quoted in order to support this concept. The curriculum has primarily been written for internists for their advanced emergency training, but it may generally show practising emergency physicians the broad spectrum of internal medicine diseases or comorbidities presented by patients attending the emergency department.
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Affiliation(s)
- Hans-Jörg Busch
- Zentrum für Notfall- und Rettungsmedizin, Universitäts-Notfallzentrum Freiburg, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Sebastian Wolfrum
- Interdisziplinäre Notaufnahme Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - Guido Michels
- Notfallzentrum, Krankenhaus der Barmherzigen Brüder Trier, Medizincampus der Universitätsmedizin Mainz, Trier, Deutschland
| | - Matthias Baumgärtel
- Klinikum Nürnberg, Universitätsklinik für Innere Medizin 3 der Paracelsus Medizinischen Privatuniversität, Nürnberg, Deutschland
| | | | - Michael Buerke
- Medizinische Klinik II, St. Marien-Krankenhaus Siegen, Siegen, Deutschland
| | - Volker Burst
- Schwerpunkt Klinische Akut- und Notfallmedizin und Klinik II für Innere Medizin, Uniklinik Köln, Köln, Deutschland
| | - Philipp Enghard
- Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Charité Universitätsmedizin, Berlin, Deutschland
| | - Georg Ertl
- Deutsches Zentrum für Herzinsuffizienz, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Wolf Andreas Fach
- MVZ CCB am AGAPLESION Bethanien Krankenhaus, Frankfurt (Main), Deutschland
| | - Frank Hanses
- Interdisziplinäre Notaufnahme, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Hans Jürgen Heppner
- Klinik für Geriatrie und Geriatrische Tagesklinik, Klinikum Bayreuth - Medizincampus Oberfranken und Friedrich-Alexander-Universität Erlangen-Nürnberg, Bayreuth, Deutschland
| | | | - Uwe Janssens
- Klinik für Innere Medizin und Internistische Intensivmedizin, St-Antonius-Hospital gGmbH, Eschweiler, Deutschland
| | - Stefan John
- Medizinische Klinik 8, Abteilung für Internistische Intensivmedizin, Klinikum Nürnberg-Süd, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - Christian Jung
- Klinik für Kardiologie, Pneumologie und Angiologie des Universitätsklinikums Düsseldorf, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland
| | - Christian Karagiannidis
- ARDS und ECMO Zentrum Köln-Merheim, Kliniken Köln und Universität Witten/Herdecke, Köln, Deutschland
| | - Michael Kiehl
- Medizinische Klinik I, Klinikum Frankfurt (Oder), Frankfurt (Oder), Deutschland
| | - Stefan Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Alexander Koch
- Medizinische Klinik III, Universitätsklinikum Aachen, Aachen, Deutschland
| | | | - Peter Korsten
- Klinik für Rheumatologie und Klinische Immunologie, St. Josef-Stift Sendenhorst, Sendenhorst, Deutschland
| | - Philipp M Lepper
- Klinik für Akut- und Notfallmedizin, Universität und Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | | | - Ursula Müller-Werdan
- Medizinische Klinik für Geriatrie und Altersmedizin, der Charité - Universitätsmedizin Berlin und EGZB, Berlin, Deutschland
| | - Martin Neukirchen
- Interdisziplinäres Zentrum für Palliativmedizin und Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Alexander Pfeil
- Klinik für Innere Medizin III, Universitätsklinikum Jena, Jena, Deutschland
| | - Reimer Riessen
- Internistische Intensivstation 93, Dept. f. Innere Medizin, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Wolfgang Rottbauer
- Klinik für Innere Medizin II (Kardiologie, Angiologie, Pneumologie, Intensivmedizin, Sport- und Rehabilitationsmedizin), Universitätsklinikum Ulm, Ulm, Deutschland
| | | | | | - Daniel Sedding
- Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06097, Halle (Saale), Deutschland
| | - Katrin Singler
- Universitätsklinik für Innere Medizin - Geriatrie & Institut für Biomedizin des Alterns, Klinikum Nürnberg Paracelsus Medizinische Privatuniversität & Friedrich-Alexander Universität Erlangen-Nürnberg, Nürnberg & Erlangen, Deutschland
| | - Marcus Thieme
- Abteilung Innere Medizin und REGIOMED Gefäßzentrum, REGIOMED Klinikum Sonneberg, Sonneberg und Klinik für Innere Medizin I, Universitätsklinikum Jena, Jena, Deutschland
| | | | - Carsten Willam
- Medizinische Klinik 4, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Karl Werdan
- Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06097, Halle (Saale), Deutschland.
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2
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Al-Alawy K, Sayegh KA, Moonesar IA. Optimizing interventional cardiology services. Future Cardiol 2023; 19:695-705. [PMID: 37916604 DOI: 10.2217/fca-2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
Cardiovascular disease (CVD) is a common and prominent cause of morbidity and mortality interventional cardiology (IC) remains an important noninvasive intervention to improve patient outcomes and life expectancy. Aim: The study objectives were to explore how IC services could be optimized. Methods: We adopted multiple methods, including policy analysis, literature review and interviews. Results: The most prominent themes were medical devices and service integration and management. IC Consultant interviews suggest the need to balance supply and demand, implement standards of practice and establish centres of excellence. Conclusion: Optimizing IC services requires a comprehensive approach, including regulatory and financial oversight, organizational management, adoption of clinical and technological best practices, ongoing training, multidisciplinary working and service integration.
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Sharma K, Wang S, Liu Y, Zhang Y, Liu T, Zhang Q, Zhong Q. Cardio-oncology in China. Curr Treat Options Oncol 2023; 24:1472-1488. [PMID: 37566213 DOI: 10.1007/s11864-023-01123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/12/2023]
Abstract
OPINION STATEMENT Cardio-oncology is going under rapid development in various areas across an increasing number of provinces in China. However there are still a myriad of challenges that need to be overcome in order to ensure its gradual and consistent expansion. The Cardio-Oncology Knowledge Transfer Model (KTM) forms the basis to allow exponential development of effective cardio-oncology services. This would ensure the implementation of precision-based practice while dynamically evolving cardio-oncology to integrate both Western and Chinese medical practices to become an official clinical sub-speciality in its own right in China, for the ultimate benefit of the patient.
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Affiliation(s)
- K Sharma
- CardioOncology (Official Cardio-Oncology Organization in China), 201, Floor 2, Building B, The Rainbow Centre, Hongqiao, Hechuan Road 3051, Minhang District, Shanghai, 201100, China.
| | - Shanshan Wang
- CardioOncology (Official Cardio-Oncology Organization in China), 201, Floor 2, Building B, The Rainbow Centre, Hongqiao, Hechuan Road 3051, Minhang District, Shanghai, 201100, China
| | - Ying Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 193 United Road, Dalian, 116021, Liaoning Province, China
| | - Yangli Zhang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 193 United Road, Dalian, 116021, Liaoning Province, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Qingling Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Qiaoqing Zhong
- Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Harvard Medical School, MA, 02215, Boston, USA
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, 410008, Changsha, China
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4
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Affiliation(s)
- Alicja Jasinska-Piadlo
- Cardiology Department, Southern Health and Social Care Trust, Portadown, UK
- School of Computing, Ulster University, Belfast, UK
| | - Patricia Campbell
- Cardiology Department, Southern Health and Social Care Trust, Portadown, UK
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Quality improvement: understanding the adoption and diffusion of digital technologies related to surgical performance. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2022. [DOI: 10.1108/ijqrm-07-2021-0234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PurposeQuantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.Design/methodology/approachIn this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.FindingsAdoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.Originality/valueThis paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.
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Yong E, Manoharan K, Gent D. The European Examination in Core Cardiology in Focus: Evaluation and Recommendations Using Educational Theory. J Eur CME 2022; 11:2055266. [PMID: 35340895 PMCID: PMC8956319 DOI: 10.1080/21614083.2022.2055266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The European Examination in Core Cardiology (EECC) is a knowledge-based postgraduate examination for cardiology specialists in Europe. It is designed to assess if a trainee has gained sufficient knowledge for independent specialist practice in core cardiology. A critical evaluation of the ECCC was undertaken using current educational theory. Miller’s Pyramid was considered, and the Utility Equation was employed in a mixed methods approach. The utility analysis findings were that the EECC measured well on reliability and validity although improvement could be made in educational impact, cost-effectiveness and accessibility. Recommendations for enhancement were then put forward. No assessment instrument is perfect, and it is important to remember that the EECC is one component of assessment strategy for specialist trainees, complementing other evidence of professional competence. After appraisal, while improvement can be made, the EECC fulfils its ambitions of assessment.
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Affiliation(s)
- Enhui Yong
- Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Karthick Manoharan
- Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - David Gent
- Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK
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7
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Tracy EP, Hughes W, Beare JE, Rowe G, Beyer A, LeBlanc AJ. Aging-Induced Impairment of Vascular Function: Mitochondrial Redox Contributions and Physiological/Clinical Implications. Antioxid Redox Signal 2021; 35:974-1015. [PMID: 34314229 PMCID: PMC8905248 DOI: 10.1089/ars.2021.0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Significance: The vasculature responds to the respiratory needs of tissue by modulating luminal diameter through smooth muscle constriction or relaxation. Coronary perfusion, diastolic function, and coronary flow reserve are drastically reduced with aging. This loss of blood flow contributes to and exacerbates pathological processes such as angina pectoris, atherosclerosis, and coronary artery and microvascular disease. Recent Advances: Increased attention has recently been given to defining mechanisms behind aging-mediated loss of vascular function and development of therapeutic strategies to restore youthful vascular responsiveness. The ultimate goal aims at providing new avenues for symptom management, reversal of tissue damage, and preventing or delaying of aging-induced vascular damage and dysfunction in the first place. Critical Issues: Our major objective is to describe how aging-associated mitochondrial dysfunction contributes to endothelial and smooth muscle dysfunction via dysregulated reactive oxygen species production, the clinical impact of this phenomenon, and to discuss emerging therapeutic strategies. Pathological changes in regulation of mitochondrial oxidative and nitrosative balance (Section 1) and mitochondrial dynamics of fission/fusion (Section 2) have widespread effects on the mechanisms underlying the ability of the vasculature to relax, leading to hyperconstriction with aging. We will focus on flow-mediated dilation, endothelial hyperpolarizing factors (Sections 3 and 4), and adrenergic receptors (Section 5), as outlined in Figure 1. The clinical implications of these changes on major adverse cardiac events and mortality are described (Section 6). Future Directions: We discuss antioxidative therapeutic strategies currently in development to restore mitochondrial redox homeostasis and subsequently vascular function and evaluate their potential clinical impact (Section 7). Antioxid. Redox Signal. 35, 974-1015.
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Affiliation(s)
- Evan Paul Tracy
- Department of Physiology, University of Louisville, Louisville, Kentucky, USA
| | - William Hughes
- Department of Medicine and Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jason E Beare
- Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky, USA.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA
| | - Gabrielle Rowe
- Department of Physiology, University of Louisville, Louisville, Kentucky, USA
| | - Andreas Beyer
- Department of Medicine and Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amanda Jo LeBlanc
- Department of Physiology, University of Louisville, Louisville, Kentucky, USA.,Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky, USA
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8
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2020 European Society of Cardiology Core Curriculum for the Cardiologist. Is it time for change in the Portuguese cardiology training program? Rev Port Cardiol 2021; 40:697.e1-697.e4. [PMID: 34503711 DOI: 10.1016/j.repce.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 11/22/2022] Open
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9
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Domingues K, Gonçalves L, Vidigal MJ, Tanner FC, Mendes M. 2020 European Society of Cardiology Core Curriculum for the Cardiologist. Is it time for change in the Portuguese cardiology training program? Rev Port Cardiol 2021. [DOI: 10.1016/j.repc.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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10
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Windecker S. ESC Committee for Practice Guidelines: providing knowledge to everyday clinical practice. Cardiovasc Res 2021; 116:e146-e148. [PMID: 32845966 DOI: 10.1093/cvr/cvaa154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland
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11
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Stankovic I, Muraru D, Fox K, Salvo GD, Hasselberg NE, Breithardt OA, Hansen TB, Neskovic AN, Gargani L, Cosyns B, Edvardsen T. Level 1 of Entrustable Professional Activities in adult echocardiography: a position statement from the EACVI regarding the training and competence requirements for selecting and interpreting echocardiographic examinations. Eur Heart J Cardiovasc Imaging 2021; 22:1091-1097. [PMID: 34383895 DOI: 10.1093/ehjci/jeab143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/20/2021] [Indexed: 11/12/2022] Open
Abstract
The goal of Level 1 training in echocardiography is to enable the trainee to select echocardiography appropriately for the evaluation of a specific clinical question, and then to interpret the report. It is not the goal of Level 1 training to teach how to perform the examination itself-that is the goal of higher levels of training. However, understanding the principles, indications, and findings of this crucial technique is valuable to many medical professionals including outside cardiology. This should be seen as part of a general understanding of cardiac imaging modalities. The purpose of this position statement is to define the scope and outline the general requirements for Level 1 training and competence in echocardiography. Moreover, the document aims to make a clear distinction between Level 1 competence in echocardiography and focus cardiac ultrasound (FoCUS).
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Affiliation(s)
- Ivan Stankovic
- Faculty of Medicine, Department of Cardiology, Clinical Hospital Center Zemun, University of Belgrade, Vukova 9, 11080 Belgrade, Serbia
| | - Denisa Muraru
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Istituto Auxologico Italiano, IRCCS, S. Luca Hospital, Piazzale Brescia 20, Milan, Italy
| | - Kevin Fox
- Department of Cardiology, Imperial College Healthcare NHS Trust, London W12 0HS, UK
| | - Giovanni Di Salvo
- Paediatric Cardiology and Congenital Heart Disease, University of Padua, Italy
| | - Nina E Hasselberg
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ole-A Breithardt
- Department of Cardiology & Rhythmology, Agaplesion Diakonie Kliniken, Academic Teaching Hospital University of Marburg, Kassel, Germany
| | - Tina B Hansen
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Aleksandar N Neskovic
- Faculty of Medicine, Department of Cardiology, Clinical Hospital Center Zemun, University of Belgrade, Vukova 9, 11080 Belgrade, Serbia
| | - Luna Gargani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Bernard Cosyns
- Department of Cardiology, Centrum voor Hart en Vaatziekten, Universitair Ziekenhuis Brussel, Belgium
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Oslo, Norway
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Cameli M, Marsan NA, D'Andrea A, Dweck MR, Fontes-Carvalho R, Manka R, Michalski B, Podlesnikar T, Sitges M, Popescu BA, Edvardsen T, Fox KF, Haugaa KH. EACVI survey on multimodality training in ESC countries. Eur Heart J Cardiovasc Imaging 2021; 20:1332-1336. [PMID: 31750533 DOI: 10.1093/ehjci/jez200] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/02/2019] [Indexed: 11/13/2022] Open
Abstract
One of the missions of the European Association of Cardiovascular Imaging (EACVI) is 'to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging'. The future of imaging involves multimodality so each imager should have the incentive and the possibility to improve its knowledge in other cardiovascular techniques. This article presents the results of a 20 questions survey carried out in cardiovascular imaging (CVI) centres across Europe. The aim of the survey was to assess the situation of experience and training of CVI in Europe, the availability and organization of modalities in each centre and to ask for vision about potential improvements in CVI at national and European level.
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Affiliation(s)
- Matteo Cameli
- Department of Cardiovascular Diseases, University of Siena, Policlinico Le Scotte, Viale Bracci 16, 53100 Siena, Italy
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Antonello D'Andrea
- Department of Cardiology, Umberto I° Hospital Nocera Inferiore (Salerno), Luigi Vanvitelli University, Corso Vittorio Emanuele 121, 80121 Naples, Italy
| | - Marc R Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Ricardo Fontes-Carvalho
- Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research & Development Unit, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Robert Manka
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Blazej Michalski
- Department of Cardiology, Medical University of Lodz, Kniaziewicza 1/5, 91-347 Lodz, Poland
| | - Tomaz Podlesnikar
- Department of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.,Department of Cardiology, University Medical Centre Ljubljana, Zaloska cesta 7, 1000 Ljubljana, Slovenia
| | - Marta Sitges
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain.,CIBERCV, Instituto de Salud Carlos III, Villarroel 170, 08036 Barcelona, Spain
| | - Bogdan A Popescu
- Department of cardiology, University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu' Sos. Fundeni 258, Sector 2, 022328 Bucharest, Romania
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Postboks 4950 Nydalen, 0424 Oslo, Norway.,University of Oslo, Postboks 1171, Blindern, 0318 Oslo, Norway
| | - Kevin F Fox
- Department of Cardiology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, UK
| | - Kristina H Haugaa
- Department of Cardiology, Oslo University Hospital, Postboks 4950 Nydalen, 0424 Oslo, Norway.,University of Oslo, Postboks 1171, Blindern, 0318 Oslo, Norway
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13
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Czerwińska-Jelonkiewicz K, Montero S, Bañeras J, Wood A, Zeid A, De Rosa S, Guerra F, Tica O, Serrano F, Bohm A, Ahrens I, Gierlotka M, Masip J, Bonnefoy E, Lettino M, Kirchhof P, Sionis A. Current status and needs for changes in critical care training: the voice of the young cardiologists. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2021; 10:94-101. [PMID: 33580774 DOI: 10.1093/ehjacc/zuaa027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/03/2020] [Accepted: 09/22/2020] [Indexed: 01/22/2023]
Abstract
AIMS The implementation of the 2013 European Society of Cardiology (ESC) Core Curriculum guidelines for acute cardiovascular care (acc) training among European countries is unknown. We aimed to evaluate the current status of acc training among cardiology trainees and young cardiologists (<40 years) from ESC countries. METHODS AND RESULTS The survey (March-July 2019) asked about details of cardiology training, self-confidence in acc technical and non-technical skills, access to training opportunities, and needs for further training in the field. Overall 614 young doctors, 31 (26-43) years old, 55% males were surveyed. Place and duration of acc training differed between countries and between centres in the same country. Although the majority of the respondents (91%) had completed their acc training, the average self-confidence to perform invasive procedures and to manage acc clinical scenarios was low-44% (27.3-70.4). The opportunities for simulation-based learning were scarce-18% (5.8-51.3), as it was previous leadership training (32%) and knowledge about key teamwork principles was poor (48%). The need for further acc training was high-81% (61.9-94.3). Male gender, higher level of training centres, professional qualifications of respondents, longer duration of acc/intensive care training, debriefings, and previous leadership training as well as knowledge about teamwork were related to higher self-confidence in all investigated aspects. CONCLUSIONS The current cardiology training program is burdened by deficits in acc technical/non-technical skills, substantial variability in programs across ESC countries, and a clear gender-related disparity in outcomes. The forthcoming ESC Core Curriculum for General Cardiology is expected to address these deficiencies.
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Affiliation(s)
- Katarzyna Czerwińska-Jelonkiewicz
- Andrzej Frycz Modrzewski Krakow University, Gustawa Herlinga-Grudzinskiego 1, 30-705 Krakow, Poland.,Harefield Hospital, Royal Brompton & Harefield NHS Foundation Trust, Hill End Road, UB9 6JH, London, UK
| | - Santiago Montero
- Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Departament de Medicina, Universitat Autònoma de Barcelona, Plaça Cívica 08193 Bellaterra, Barcelona, Spain
| | - J Bañeras
- Acute Cardiovascular Care Unit, Department of Cardiology, Centre de Simulació Clínica Avançada VHISCA, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, 119, 08035 Barcelona, Spain
| | - A Wood
- University Hospital of Leicester, Leicester, LE3 9QP, UK
| | - A Zeid
- El Maamoura Chest Hospital-Cardiology Department, Alexandria, Egypt
| | - S De Rosa
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, 88100 Calabria, Italy
| | - F Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Ospedali Riuniti Umberto I - Lancisi - Salesi", 60121 Ancona Italy
| | - O Tica
- Faculty of Medicine and Pharmacy, Medical Discipline, University of Oradea, 1st of December Square, no 10, Oradea, Bihor County, Romania
| | - F Serrano
- The European Society of Cardiology, Sophia Antipolis, CS 80179 Biot, France
| | - A Bohm
- Department of Acute Cardiology, National Institute of Cardiovascular Diseases, 833 48 Bratislava 37, Slovakia
| | - I Ahrens
- Cardiology and Medical Intensive Care, Augustinerinnen Hospital, 50678 Cologne, Germany
| | - M Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, pl. Kopernika 11a 45-040 Opole, Poland
| | - J Masip
- Intensive Care Department, Consorci Sanitari Integral University of Barcelona, Barcelona, AVENIDA JOSEP MOLINS, 29 - 41 08906, Spain
| | - E Bonnefoy
- Intensive Cardiac Care Unit, Cardiologic Hospital Louis Pradel, Hospices Civils de Lyon, Université Lyon 1, 69002 Lyon, France
| | - M Lettino
- Cardiovascular Department, San Gerardo Hospital, ASST-Monza, Via Pegolesi 33 20900 Monza, Italy
| | - P Kirchhof
- Institute of Cardiovascular Sciences, University of Birmingham, B15 2TT Birmingham, UK.,University Heart and Vascular Center, UKE Hamburg, Martinistraße 52 20246, Hamburg, Germany
| | - A Sionis
- Intensive Cardiac Care Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
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14
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Popescu (Chair) BA, Stefanidis A, Fox KF, Cosyns B, Delgado V, Di Salvo GD, Donal E, Flachskampf FA, Galderisi M, Lancellotti P, Muraru D, Sade LE, Edvardsen T. Training, competence, and quality improvement in echocardiography: the European Association of Cardiovascular Imaging Recommendations: update 2020. Eur Heart J Cardiovasc Imaging 2020; 21:1305-1319. [DOI: 10.1093/ehjci/jeaa266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 12/19/2022] Open
Abstract
Abstract
The primary mission of the European Association of Cardiovascular Imaging (EACVI) is ‘to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging’. Echocardiography is a key component in the evaluation of patients with known or suspected cardiovascular disease and is essential for the high quality and effective practice of clinical cardiology. The EACVI aims to update the previously published recommendations for training, competence, and quality improvement in echocardiography since these activities are increasingly recognized by patients, physicians, and payers. The purpose of this document is to provide the general requirements for training and competence in echocardiography, to outline the principles of quality evaluation, and to recommend a set of measures for improvement, with the ultimate goal of raising the standards of echocardiographic practice. Moreover, the document aims to provide specific guidance for advanced echo techniques, which have dramatically evolved since the previous publication in 2009.
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Affiliation(s)
- Bogdan A Popescu (Chair)
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila” - Euroecolab, Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Sos. Fundeni 258, 022328 Bucharest, Romania
| | | | - Kevin F Fox
- Department of Cardiology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, UK
| | - Bernard Cosyns
- Department of Cardiology, Centrum voor Hart en vaatziekten (CHVZ), Universitair Ziekenhuis Brussel, 101 Laarbeeklaan, 1090 Brussels, Belgium
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Albinusdreef 2, Leiden 2300RC, The Netherlands
| | | | - Erwan Donal
- Service de Cardiologie Et Maladies Vasculaires Et CIC-IT 1414, CHU Rennes, 35000 Rennes, France
- Université de Rennes 1, LTSI, 35000 Rennes, France
| | - Frank A Flachskampf
- Department of Medical Sciences, Uppsala University, Clinical Physiology and Cardiology, Uppsala University Hospital, Uppsala, Sweden
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Anthea Hospital, Bari, Italy
| | - Denisa Muraru
- Department of Cardiac, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, P.le Brescia 201, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Leyla Elif Sade
- Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Thor Edvardsen
- Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
- Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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15
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Association for European Paediatric and Congenital Cardiology recommendations for basic training in paediatric and congenital cardiology 2020. Cardiol Young 2020; 30:1572-1587. [PMID: 33109300 DOI: 10.1017/s1047951120003455] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The recommendations of the Association for European Paediatric and Congenital Cardiology for basic training in paediatric and congenital cardiology required to be recognised as a paediatric cardiologist by the Association for European Paediatric and Congenital Cardiology are described below. Those wishing to achieve more advanced training in particular areas of paediatric cardiology should consult the training recommendations of the different Association for European Paediatric and Congenital Cardiology Working Groups available on the Association for European Paediatric and Congenital Cardiology website (www.aepc.org) and the respective publications 1-6. The development of training requirements is the responsibility of the Educational Committee and the Association for European Paediatric and Congenital Cardiology Council in collaboration with the Working Groups of the Association for European Paediatric and Congenital Cardiology. Trainees should be exposed to all aspects of general paediatric and congenital cardiology from fetal life to adolescence and adulthood. Centres performing generalised and specialised work in paediatric and congenital cardiology should be committed to deliver postgraduate training. At each training institute, trainers should be appointed to supervise and act as mentors to the trainees. Association for European Paediatric and Congenital Cardiology will provide basic teaching courses to supplement the training process.
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16
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Madamanchi C, Di Carli MF, Blankstein R. What is Multimodality Cardiovascular Imaging and How Can It Be Delivered? Heart 2020; 107:heartjnl-2019-316214. [PMID: 33109711 DOI: 10.1136/heartjnl-2019-316214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Chaitanya Madamanchi
- Departments of Medicine (Cardiovascular Division) and Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Marcelo F Di Carli
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Ron Blankstein
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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17
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Tanner FC, Brooks N, Fox KF, Gonçalves L, Kearney P, Michalis L, Pasquet A, Price S, Bonnefoy E, Westwood M, Plummer C, Kirchhof P. ESC Core Curriculum for the Cardiologist. Eur Heart J 2020; 41:3605-3692. [PMID: 32862226 DOI: 10.1093/eurheartj/ehaa641] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Felix C Tanner
- Cardiology, University Heart Center Zürich, Rämistrasse 100, Zürich, CH-8091, Switzerland
| | | | - Kevin F Fox
- Consultant Cardiologist, Imperial College, London, UK
| | - Lino Gonçalves
- Department of Cardiology, Coimbra University Hospital Center, Coimbra, Portugal
| | - Peter Kearney
- Physician Cardiologist, Cork University Hospital, Cork, Ireland
| | - Lampros Michalis
- 2nd Department of Cardiology, University Hospital of Ioannina, Greece
| | - Agnès Pasquet
- Clinical Cardiologist, Département de pathologie Cardiovasculaire, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Susanna Price
- Consultant Cardiologist and Intensivist, Royal Brompton Hospital, London, UK
| | - Eric Bonnefoy
- Chef de Service, Service de Cardiologie, Hopital Louis Pradel, Bron, France
| | - Mark Westwood
- Consultant Cardiologist, Barts Heart Centre, St. Bartholomew's Hospital, London, UK
| | - Chris Plummer
- Cardiology, University Heart Center Zürich, Rämistrasse 100, Zürich, CH-8091, Switzerland
| | - Paulus Kirchhof
- Cardiology, University Heart Center Zürich, Rämistrasse 100, Zürich, CH-8091, Switzerland
- Retired Cardiologist, Manchester, UK
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistraße 52, Gebäude Ost 70, Hamburg, 20246, Germany
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18
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Crea F. The growing non-pharmacological armamentarium for the treatment of cardiovascular diseases: from drug-coated balloons to drug-eluting stents, extracorporeal membrane oxygenation, and stem cells. Eur Heart J 2020; 41:3593-3597. [PMID: 33216880 DOI: 10.1093/eurheartj/ehaa854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
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19
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Godoy LC, Farkouh ME, Manta ICKA, Dalçóquio TF, Furtado RHDM, Yu EHC, Gun C, Nicolau JC. Cardiology Training in Brazil and Developed Countries: Some Ideas for Improvement. Arq Bras Cardiol 2019; 113:768-774. [PMID: 31691759 PMCID: PMC7020868 DOI: 10.5935/abc.20190212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/04/2019] [Indexed: 11/20/2022] Open
Abstract
Huge variations exist in cardiology training programs across the world. In developing (middle-income) countries, such as Brazil, to find the right balance between training improvements and social and economic conditions of the country may be a difficult task. Adding more training years or different mandatory rotations, for instance, may be costly and not have an immediate direct impact on enhancing patient care or public health. In this text, we compare the Brazilian cardiology training system with other proposals implemented in developed countries from North America and Europe, aiming to point out issues worth of future discussion. Factors such as training rotations and competencies, and program duration and distribution across the countries are presented. The number of first year cardiology trainees per inhabitants is similar between Brazil and the United States (0.24 medical residents/100,000 inhabitants in Brazil and 0.26 medical residents/100,000 inhabitants in the USA). These numbers should be analyzed considering the inequality in training program distribution across Brazil, since most centers are located in the Southeast and South regions. Having more residency programs in distant areas could improve cardiovascular care in these areas. Duration of cardiology Residency Training is shorter in Brazil (two years) in comparison with developed countries (> 3 years). Brazilian residency programs give less emphasis to scientific research and diagnostic methods. Unifying minimum training requirements across the globe would facilitate the development of international learning opportunities and even professional exchange around the world.
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Affiliation(s)
- Lucas Colombo Godoy
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP - Brazil.,Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON - Canada
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON - Canada
| | - Isabela C K Abud Manta
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP - Brazil
| | - Talia F Dalçóquio
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP - Brazil
| | - Remo Holanda de Mendonça Furtado
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP - Brazil.,Brigham and Women´s Hospital, Harvard Medical School, Boston, MA - USA
| | - Eric H C Yu
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON - Canada
| | - Carlos Gun
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
| | - José Carlos Nicolau
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP - Brazil
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20
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Banerjee I, McNulty JP, Catania D, Maccagni D, Masterson L, Portelli JL, Rainford L. An Investigation of Procedural Radiation Dose Level Awareness and Personal Training Experience in Communicating Ionizing Radiation Examinations Benefits and Risks to Patients in Two European Cardiac Centers. HEALTH PHYSICS 2019; 117:76-83. [PMID: 31136364 DOI: 10.1097/hp.0000000000001049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Cardiac interventional practitioners need to be appropriately informed regarding radiation dose quantities and risks. Communicating benefit-risk information to patients requires attention as specified in Basic Safety Standards Directive 2013/59/Eurotom. This study investigated the awareness of procedural radiation dose levels and the impact of personal training experience in communicating ionizing radiation benefit-risks to patients. METHODOLOGY A questionnaire, consisting of 28 questions, was distributed directly to adult and pediatric interventional cardiology specialists at specialized cardiovascular imaging centers in Dublin, Ireland and Milan, Italy. RESULTS A total of 18 interventional cardiologists (senior registrar to consultant grades with between 2 y to over 21 y experience in cardiac imaging) participated. The majority of participants (n = 17) stated that parents of pediatric and adult patients should be informed of the potential benefits and risk. All participants indicated they had radiation safety training; however, 50% had not received training in radiation examination benefit-risk communication. Despite this, 77.8% (n = 14) participants indicated a high confidence level in successfully explaining risks and/or benefits of cardiac imaging procedures. When asked to estimate effective dose (ED) values for common cardiac imaging procedures less than 50% identified appropriate dose ranges. All participants underestimated procedural dose values based on recent European data. 50% (n = 9) participants answered all questions correctly for a number of true or false radiation risk statements. CONCLUSION Benefit-risk communication training deficits and inaccurate understanding of radiation dose levels was identified. Further research and training to support clinicians using radiation on a daily basis is required.
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Affiliation(s)
- I Banerjee
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - J P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - D Catania
- AITRI, Association of Italian Interventional Radiographers, Milan, Italy
| | | | - L Masterson
- Our Lady's University Children's Hospital, Crumlin, Dublin, Ireland
| | - J L Portelli
- Department of Radiography, Faculty of Health Sciences, University of Malta
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
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21
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Chioncel O, Collins SP, Ambrosy AP, Pang PS, Radu RI, Ahmed A, Antohi EL, Masip J, Butler J, Iliescu VA. Therapeutic Advances in the Management of Cardiogenic Shock. Am J Ther 2019; 26:e234-e247. [PMID: 30839372 PMCID: PMC6404765 DOI: 10.1097/mjt.0000000000000920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cardiogenic shock (CS) is a life-threatening state of tissue hypoperfusion, associated with a very high risk of mortality, despite intensive monitoring and modern treatment modalities. The present review aimed at describing the therapeutic advances in the management of CS. AREAS OF UNCERTAINTY Many uncertainties about CS management remain in clinical practice, and these relate to the intensity of invasive monitoring, the type and timing of vasoactive therapies, the risk-benefit ratio of mechanical circulatory support (MCS) therapy, and optimal ventilation mode. Furthermore, most of the data are obtained from CS in the setting of acute myocardial infarction (AMI), although for non-AMI-CS patients, there are very few evidences for etiological or MCS therapies. DATA SOURCES The prospective multicentric acute heart failure registries that specifically presented characteristics of patients with CS, distinct to other phenotypes, were included in the present review. Relevant clinical trials investigating therapeutic strategies in post-AMI-CS patients were added as source information. Several trials investigating vasoactive medications and meta-analysis providing information about benefits and risks of MCS devices were reviewed in this study. THERAPEUTIC ADVANCES Early revascularization remains the most important intervention for CS in settings of AMI, and in patients with multivessel disease, recent trial data recommend revascularization on a "culprit-lesion-only" strategy. Although diverse types of MCS devices improve hemodynamics and organ perfusion in patients with CS, results from almost all randomized trials incorporating clinical end points were inconclusive. However, development of new algorithms for utilization of MCS devices and progresses in technology showed benefit in selected patients. A major advance in the management of CS is development of concept of regional CS centers based on the level of facilities and expertise. The modern systems of care with CS centers used as hubs integrated with emergency medical systems and other referee hospitals have the potential to improve patient outcomes. CONCLUSIONS Additional research is needed to establish new triage algorithms and to clarify intensity and timing of pharmacological and mechanical therapies.
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Affiliation(s)
- Ovidiu Chioncel
- University of Medicine Carol Davila, Bucharest; Emergency Institute for Cardiovascular Diseases-“Prof. C.C.Iliescu”, Bucharest, Romania
| | - Sean P Collins
- Department of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Andrew P Ambrosy
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
| | - Peter S Pang
- Department of Emergency Medicine and Indianapolis EMS, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Razvan I Radu
- University of Medicine Carol Davila, Bucharest; Emergency Institute for Cardiovascular Diseases-“Prof. C.C.Iliescu”, Bucharest, Romania
| | - Ali Ahmed
- Veteran Affairs Medical Center and George Washington University, Washington DC, USA
| | - Elena-Laura Antohi
- University of Medicine Carol Davila, Bucharest; Emergency Institute for Cardiovascular Diseases-“Prof. C.C.Iliescu”, Bucharest, Romania
| | - Josep Masip
- Cardiology Department, Hospital Sanitas CIMA, Barcelona, Spain; Department of Intensive Care, Consorci Sanitari Integral, Barcelona, Spain
| | - Javed Butler
- Department of Medicine, University of Mississippi School of Medicine, Jackson, MI, USA
| | - Vlad Anton Iliescu
- University of Medicine Carol Davila, Bucharest; Emergency Institute for Cardiovascular Diseases-“Prof. C.C.Iliescu”, Bucharest, Romania
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22
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Kotecha D, Bax JJ, Carrera C, Casadei B, Merkely B, Anker SD, Vardas PE, Kearney PP, Roffi M, Ros M, Vahanian A, Weidinger F, Beeri R, Budaj A, Calabrò P, Czerwińska-Jelonkiewicz K, D'Ascenzi F, De Potter T, Fox KF, Hartikainen J, McAdam B, Milicic D, Pasquet AA, Sionis A, Sohaib SMA, Tsioufis C, Verhorst PMJ, Kirchhof P. Roadmap for cardiovascular education across the European Society of Cardiology: inspiring better knowledge and skills, now and for the future. Eur Heart J 2019; 40:1728-1738. [PMID: 30226525 DOI: 10.1093/eurheartj/ehy058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/14/2017] [Accepted: 01/24/2018] [Indexed: 11/13/2022] Open
Abstract
AIMS The provision of high-quality education allows the European Society of Cardiology (ESC) to achieve its mission of better cardiovascular practice and provides an essential component of translating new evidence to improve outcomes. METHODS AND RESULTS The 4th ESC Education Conference, held in Sophia Antipolis (December 2016), brought together ESC education leaders, National Directors of Training of 43 ESC countries, and representatives of the ESC Young Community. Integrating national descriptions of education and cardiology training, we discussed innovative pathways to further improve knowledge and skills across different training programmes and health care systems. We developed an ESC roadmap supporting better cardiology training and continued medical education (CME), noting: (i) The ESC provides an excellent framework for unbiased and up-to-date cardiovascular education in close cooperation with its National Societies. (ii) The ESC should support the harmonization of cardiology training, curriculum development, and professional dialogue and mentorship. (iii) ESC congresses are an essential forum to learn and discuss the latest developments in cardiovascular medicine. (iv) The ESC should create a unified, interactive educational platform for cardiology training and continued cardiovascular education combining Webinars, eLearning Courses, Clinical Cases, and other educational programmes, along with ESC Congress content, Practice Guidelines and the next ESC Textbook of Cardiovascular Medicine. (v) ESC-delivered online education should be integrated into National and regional cardiology training and CME programmes. CONCLUSION These recommendations support the ESC to deliver excellent and comprehensive cardiovascular education for the next generation of specialists. Teamwork between international, national and local partners is essential to achieve this objective.
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Abstract
PURPOSE OF REVIEW With the rapid development of novel cancer therapeutics and the growing number of cancer survivors, there is significant demand for cardio-oncology experts to care for these patients. As such, it has become increasingly necessary to develop formalized training in the field of cardio-oncology. This review will focus on the current state of cardio-oncology education, with recommendations for the development of dedicated cardio-oncology fellowships. RECENT FINDINGS Cardio-oncology fellowships should be affiliated with high-volume centers that have established cardio-oncology clinical and research programs with dedicated cardio-oncology faculty. Several recent publications have proposed recommendations to develop uniform cardio-oncology training standards, core curricula, and evaluation metrics. With the rapid evolution of the field and the support of various profession organizations, the number and quality of dedicated cardio-oncology fellowship programs is expected to increase significantly. The adoption of defined training requirements and evaluation standards to measure competency will be essential to ensure the legitimacy and success of the field.
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Affiliation(s)
- Michael G Fradley
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Morsani College of Medicine and H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, 12902 USF Magnolia Dr., MCB-CPT, Tampa, FL, 33612-9416, USA.
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25
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Frederix I, Caiani EG, Dendale P, Anker S, Bax J, Böhm A, Cowie M, Crawford J, de Groot N, Dilaveris P, Hansen T, Koehler F, Krstačić G, Lambrinou E, Lancellotti P, Meier P, Neubeck L, Parati G, Piotrowicz E, Tubaro M, van der Velde E. ESC e-Cardiology Working Group Position Paper: Overcoming challenges in digital health implementation in cardiovascular medicine. Eur J Prev Cardiol 2019; 26:1166-1177. [DOI: 10.1177/2047487319832394] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ines Frederix
- Department of Cardiology, Jessa Hospital, Belgium
- Antwerp University Hospital (UZA), Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Belgium
| | - Enrico G Caiani
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Italy
- Institute of Electronics and Information and Telecommunication Engineering, Consiglio Nazionale delle Ricerche, Italy
| | - Paul Dendale
- Department of Cardiology, Jessa Hospital, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
| | - Stefan Anker
- Division of Cardiology and Metabolism, Berlin–Brandenburg Center for Regenerative Therapies (BCRT), partner site Berlin, Charité Universitätsmedizin Berlin, Germany
| | - Jeroen Bax
- Department of Cardiology, Leiden University Medical Centre (LUMC), The Netherlands
| | - Alan Böhm
- Department of Acute Cardiology, The National Institute of Cardiovascular Diseases, Slovakia
- Faculty of Medicine, Slovak Medical University, Slovakia
| | - Martin Cowie
- National Heart and Lung Institute, Imperial College London, UK
| | - John Crawford
- International Advisory Group, Healthcare Information and Management Systems Society (HIMSS), UK
| | - Natasja de Groot
- Department of Cardiology, Erasmus Medical Center, The Netherlands
| | | | - Tina Hansen
- Department of Cardiology, Zealand University Hospital, Denmark
| | - Friedrich Koehler
- Centre for Cardiovascular Telemedicine, Charité – Universitätsmedizin, Germany
| | | | | | - Patrizio Lancellotti
- University of Liège Hospital, GIGA CardioVascular Sciences, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Italy
| | - Pascal Meier
- Department of Cardiology, University Hospital Geneva HUG, Switzerland
| | - Lis Neubeck
- School of Health and Social Care, Edinburgh Napier University, UK
| | - Gianfranco Parati
- IRCCS Istituto Auxologico Italiano, University of Milano-Bicocca, Italy
| | | | - Marco Tubaro
- ICCU – Cardiology Division, San Filippo Neri Hospital, Italy
| | - Enno van der Velde
- Department of Cardiology, Leiden University Medical Centre (LUMC), The Netherlands
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26
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Peeters LEJ, Kester MP, Feyz L, Van Den Bemt PMLA, Koch BCP, Van Gelder T, Versmissen J. Pharmacokinetic and pharmacodynamic considerations in the treatment of the elderly patient with hypertension. Expert Opin Drug Metab Toxicol 2019; 15:287-297. [PMID: 30880496 DOI: 10.1080/17425255.2019.1588249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Hypertension is an important risk factor for developing cardiovascular diseases. It is more prevalent in the elderly population. Recently updated American and European guidelines recommend treating every elderly patient with hypertension independent of age, starting with a low dose of antihypertensive drugs. However, little information is available on the optimal dosages of antihypertensive drugs to treat the elderly safely. Areas covered: Comorbidities, co-medication and frailty status can alter the clinical outcome of drug treatment and can cause adverse events in the elderly. Also, due to pharmacokinetic and pharmacodynamic changes the interpatient variability when using antihypertensive drugs is considerable. In this review, an overview is given on the extent to which the previously mentioned parameters are changed in elderly patients and what this means for the exposure to antihypertensive medication. Also, recommendations on the starting dose of the most frequently used antihypertensive drugs are given based on literature data. Expert opinion: We believe that recommendations on starting dosages followed by a stepwise increase of dosages will lead to improved blood pressure control and less adverse drug reactions in the elderly patient. This may improve adherence to antihypertensive therapy.
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Affiliation(s)
- L E J Peeters
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.,b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - M P Kester
- b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - L Feyz
- c Department of Cardiology , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - P M L A Van Den Bemt
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - B C P Koch
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - T Van Gelder
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.,b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - J Versmissen
- b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
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Gustavsen PH, Nielsen DG, Paltved C, Konge L, Nayahangan LJ. A national needs assessment study to determine procedures for simulation-based training in cardiology in Denmark. SCAND CARDIOVASC J 2019; 53:35-41. [PMID: 30649966 DOI: 10.1080/14017431.2019.1569716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES New training methods such as simulation have been introduced in cardiology as in other specialties; however, the development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The objective of this study was to perform a nationwide general needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum for cardiology residency in Denmark. DESIGN We completed a needs assessment using the Delphi method among key opinion leaders in cardiology. Brainstorming in round 1 identified technical procedures that future cardiologists should learn. Round 2 was a survey to examine frequency of procedure, number of cardiologists performing the procedure, operator-related risk and/or discomfort for patients and feasibility for simulation. Round 3 was final elimination and prioritization of procedures. RESULTS Ninety-four key opinion leaders were included, and the response rates were 77% (round 1), 62% (Round 2), and 68% (Round 3). Twenty-four technical procedures were identified in Round 1 and pre-prioritized in Round 2. In round 3, 13 procedures were included in the final prioritized list. The five highly prioritized procedures eligible for simulation-based training were advanced life support, pleurocentesis, transesophageal echocardiography, coronary angiography, and pericardiocentesis. CONCLUSION The general needs assessment following the Delphi process identified and prioritized 13 technical procedures in cardiology that should be integrated in a simulation-based curriculum. The final list provides educators a guide when developing simulation-based training programmes for cardiology residents.
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Affiliation(s)
- Pia Helene Gustavsen
- a Copenhagen Academy for Medical Education and Simulation (CAMES) , The Capital Region of Denmark, Copenhagen , Denmark.,b Department of Cardiology, Herlev Gentofte Hospital , Copenhagen University Hospital , Copenhagen , Denmark
| | | | - Charlotte Paltved
- d MidtSim - Centre for Human Resources , Central Region of Denmark and Aarhus University , Aarhus , Denmark
| | - Lars Konge
- a Copenhagen Academy for Medical Education and Simulation (CAMES) , The Capital Region of Denmark, Copenhagen , Denmark.,e Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Leizl Joy Nayahangan
- a Copenhagen Academy for Medical Education and Simulation (CAMES) , The Capital Region of Denmark, Copenhagen , Denmark
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Neskovic AN, Skinner H, Price S, Via G, De Hert S, Stankovic I, Galderisi M, Donal E, Muraru D, Sloth E, Gargani L, Cardim N, Stefanidis A, Cameli M, Habib G, Cosyns B, Lancellotti P, Edvardsen T, Popescu BA. Focus cardiac ultrasound core curriculum and core syllabus of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2019. [PMID: 29529170 DOI: 10.1093/ehjci/jey006] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is a growing trend of using ultrasound examination of the heart as a first-line diagnostic tool for initial patient evaluation in acute settings. Focus cardiac ultrasound (FoCUS) is a standardized but restricted cardiac ultrasound examination that may be undertaken by a range of medical professionals with diverse backgrounds. The intention of this core curriculum and syllabus is to define a unifying framework for educational and training processes/programmes that should result in competence in FoCUS for various medical professionals dealing with diagnostics and treatment of cardiovascular emergencies. The European Association of Cardiovascular Imaging prepared this document in close cooperation with representatives of the European Society of Anaesthesiology, the European Association of Cardiothoracic Anaesthesiology, the Acute Cardiovascular Care Association of the European Society of Cardiology and the World Interactive Network Focused On Critical Ultrasound. It aims to provide the key principles and represents a guide for teaching and training of FoCUS. We offer this document to the emergency and critical care community as a reference outline for teaching materials and courses related to FoCUS, for promoting teamwork and encouraging the development of the field.
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Affiliation(s)
- Aleksandar N Neskovic
- Department of Cardiology, Clinical Hospital Center Zemun, Vukova 9, 11080 Belgrade, Faculty of Medicine, University of Belgrade, Serbia
| | - Henry Skinner
- Department of Anaesthesiology, Nottingham University Hospitals, Hucknall Rd, Nottingham NG5 1PB, UK
| | - Susanna Price
- Adult Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK
| | - Gabriele Via
- Department of Anesthesia and Intensive Care, Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Stefan De Hert
- Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Ivan Stankovic
- Department of Cardiology, Clinical Hospital Center Zemun, Vukova 9, 11080 Belgrade, Faculty of Medicine, University of Belgrade, Serbia
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5, 80131 Napoli, Italy
| | - Erwan Donal
- Department of Cardiology, University Hospital of Rennes, rue H Le Guillou - Hôpital Pontchaillou, 35000 Rennes, France
| | - Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128 Padua, Italy
| | - Erik Sloth
- Department of Anaesthesiology and Intensive Care Medicine, Operation and Intensive Care East Section, Aarhus University Hospital, Skejby, 99 Palle Juul-Jensens Boulevard, 8200 Aarhus N, Denmark
| | - Luna Gargani
- Institute of Clinical Physiology - National Research Council, Via Moruzzi 1, 56124 Pisa, Italy
| | - Nuno Cardim
- Cardiology Department, Hospital da Luz, Av. Lusíada, n° 100 - 1500-650 Lisbon, Portugal
| | | | - Matteo Cameli
- Department of Cardiovascular Diseases, University of Siena, Viale Bracci 1, Policlinico Le Scotte, 53100 Siena, Italy
| | - Gilbert Habib
- APHM, La Timone Hospital, Cardiology Department, Boulevard Jean Moulin, 13005 Marseille, France.,Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Boulevard Jean Moulin, 13005, Marseille, France
| | - Bernard Cosyns
- Centrum voor Hart en Vaatziekten (CHVZ), Unversitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, Domaine Universitaire du Sart Tilman - B.35?-?4000 Liège, Belgium
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Sognvannsveien 20, NO-0027 Oslo, Norway
| | - Bogdan A Popescu
- Cardiology Department, University of Medicine and Pharmacy 'Carol Davila' - Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
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29
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Influencia de la experiencia profesional del cardiólogo clínico sobre la adecuación de las indicaciones clínicas de la gated-SPECT de perfusión miocárdica. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2018; 88:386-390. [DOI: 10.1016/j.acmx.2017.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/29/2017] [Accepted: 11/06/2017] [Indexed: 11/21/2022] Open
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30
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Liu Y, Zhang YL, Liu JW, Fang FQ, Li JM, Xia YL. Emergence, Development, and Future of Cardio-Oncology in China. Chin Med J (Engl) 2018; 131:2640-2644. [PMID: 30381608 PMCID: PMC6213845 DOI: 10.4103/0366-6999.244101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Ying Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
| | - Yan-Li Zhang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
| | - Ji-Wei Liu
- Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
| | - Feng-Qi Fang
- Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
| | - Jian-Ming Li
- Cardiovascular Division, University of Minnesota, Minneapolis, MN 55417, USA
| | - Yun-Long Xia
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China
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31
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Fox K, Achenbach S, Bax J, Cosyns B, Delgado V, Dweck MR, Edvardsen T, Flachskampf F, Habib G, Lancellotti P, Muraru D, Neglia D, Pontone G, Schwammenthal E, Sechtem U, Westwood M, Popescu BA. Multimodality imaging in cardiology: a statement on behalf of the Task Force on Multimodality Imaging of the European Association of Cardiovascular Imaging. Eur Heart J 2018; 40:553-558. [DOI: 10.1093/eurheartj/ehy669] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/04/2018] [Indexed: 02/07/2023] Open
Affiliation(s)
- Kevin Fox
- Department of Cardiology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, UK
| | - Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-University Faculty of Medicine, Krankenhausstraße 12, Erlangen, Germany
| | - Jeroen Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Bernard Cosyns
- Cardiology Department, CHVZ (Centrum voor Hart en Vaatziekten) - Universtair Ziekhenhuis Brussel, 101 Laarbeklaan, Brussels, Belgium
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Marc R Dweck
- Centre for Cardiovascular Science, University of Edinburgh, Little France Crescent, Edinburgh, UK
| | - Thor Edvardsen
- Oslo University Hospital, Department of Cardiology, Rikshospitalet and University of Oslo Sognsvannsveien 20, Oslo, Norway
| | - Frank Flachskampf
- Department of Medical Sciences, Uppsala University, Clinical Physiology and Cardiology, Akademiska, Uppsala, Sweden
| | - Gilbert Habib
- APHM, La Timone Hospital, Cardiology Department, Rue Saint-Pierre, Marseille Cedex 5, France
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, 27 Boulevard Jean Moulin, Marseille, CEDEX 5, France
| | - Patrizio Lancellotti
- University of Liège Hospital, Department of Cardiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, VIA C. ROSALBA, Bari, Italy
| | - Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, Padua, Italy
| | - Danilo Neglia
- Fondazione Toscana G. Monasterio (FTGM), Cardiovascular Department, Via Giuseppe Moruzzi, 1, Pisa, Italy
- Scuola Superiore Sant'Anna, Institute of Life Sciences, Via Santa Cecilia, n., Pisa, Italy
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Via Carlo Parea 4, Milan, Italy
| | - Ehud Schwammenthal
- Tel Aviv University and Heart Center Sheba Medical Center, Emek Doran St, Ramat Gan, Israel
| | - Udo Sechtem
- Department of Cardiology, Robert Bosch Krakenhaus, Auerbachstraße 110, Stuttgart, Germany
| | - Mark Westwood
- Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, UK
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila” - Euroecolab, Emergency Institute of Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Sos. Fundeni 258, Sector 2, Bucharest, Romania
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32
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Senior R, Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL, Nihoyannopoulos P, Edvardsen T, Lancellotti P. Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017. Eur Heart J Cardiovasc Imaging 2018; 18:1205-1205af. [PMID: 28950366 DOI: 10.1093/ehjci/jex182] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 12/16/2022] Open
Abstract
Contrast echocardiography is widely used in cardiology. It is applied to improve image quality, reader confidence and reproducibility both for assessing left ventricular (LV) structure and function at rest and for assessing global and regional function in stress echocardiography. The use of contrast in echocardiography has now extended beyond cardiac structure and function assessment to evaluation of perfusion both of the myocardium and of the intracardiac structures. Safety of contrast agents have now been addressed in large patient population and these studies clearly established its excellent safety profile. This document, based on clinical trials, randomized and multicentre studies and published clinical experience, has established clear recommendations for the use of contrast in various clinical conditions with evidence-based protocols.
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Affiliation(s)
- Roxy Senior
- Department of Cardiology, Royal Brompton Hospital, Imperial College, Sydney Street, London SW3 6NP, UK
| | | | | | | | - Jose Zamorano
- CIBERCV, University Hospital Ramón y Cajal, Madrid, Spain
| | | | | | | | - Patrizio Lancellotti
- University of Liege Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liege, Belgium
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Kotecha D, Chua WWL, Fabritz L, Hendriks J, Casadei B, Schotten U, Vardas P, Heidbuchel H, Dean V, Kirchhof P. European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers. Europace 2018; 20:225-233. [PMID: 29040548 PMCID: PMC5834097 DOI: 10.1093/europace/eux299] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/02/2017] [Indexed: 01/02/2023] Open
Abstract
We are in the midst of a digital revolution in health care, although the application of new and useful technology in routine clinical practice is variable. The Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly (CATCH ME) Consortium, in collaboration with the European Society of Cardiology (ESC), has funded the creation of two applications (apps) in atrial fibrillation (AF) for use in smartphones and tablets. The patient app aims to enhance patient education, improve communication between patients and health care professionals, and encourage active patient involvement in the management of their condition. The health care professional app is designed as an interactive management tool incorporating the new ESC Practice Guidelines on AF and supported by the European Heart Rhythm Association (EHRA), with the aim of improving best practice approaches for the care of patients with AF. Both stand-alone apps are now freely available for Android and iOS devices though the Google Play, Amazon, and Apple stores. In this article, we outline the rationale for the design and implementation of these apps. Our objective is to demonstrate the value of integrating novel digital technology into clinical practice, with the potential for patient engagement, optimization of pharmacological and interventional therapy in AF, and ultimately to improve patient outcomes.
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Affiliation(s)
- Dipak Kotecha
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
- Cardiology Department, University Hospitals Birmingham NHS Trust and Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Corresponding author. Tel: +44 121 371 8122; fax: +44 121 371 4175. E-mail address:
| | - Winnie W L Chua
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
| | - Larissa Fabritz
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
- Cardiology Department, University Hospitals Birmingham NHS Trust and Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Department of Cardiovascular Medicine, University Hospital Muenster, Germany
| | - Jeroen Hendriks
- Centre for Heart Rhythm Disorders, University of Adelaide, Australia
- Department of Medical and Health Sciences, University of Linköping, Sweden
| | - Barbara Casadei
- Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Ulrich Schotten
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+ and Maastricht Centre for Systems Biology, Maastricht, The Netherlands
| | - Panos Vardas
- Cardiology Department, University Hospital of Heraklion, Crete, Greece
| | - Hein Heidbuchel
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Veronica Dean
- European Society of Cardiology, Sophia-Antipolis, France
| | - Paulus Kirchhof
- University of Birmingham Institute of Cardiovascular Sciences, The Medical School, Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK
- Cardiology Department, University Hospitals Birmingham NHS Trust and Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Department of Cardiovascular Medicine, University Hospital Muenster, Germany
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34
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Pontone G, Moharem-Elgamal S, Maurovich-Horvat P, Gaemperli O, Pugliese F, Westwood M, Stefanidis A, Fox KF, Popescu BA. Training in cardiac computed tomography: EACVI certification process. Eur Heart J Cardiovasc Imaging 2017; 19:123-126. [PMID: 29236986 DOI: 10.1093/ehjci/jex310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Imaging, Via Carlo Parea 4, 20138 Milan, Italy
| | - Sarah Moharem-Elgamal
- National Heart Institute, Cardiology Department, 5 Ibn Nafise Square, Imbaba Giza 11111, Egypt
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group (CIRG), Heart and Vascular Center, Semmelweis University, 8 Varosmajor u. 1122 Budapest, Hungary
| | - Oliver Gaemperli
- University Heart Center, Ramistrasse 100, CH-8091, Zurich, Switzerland
| | - Francesca Pugliese
- NIHR Barts BRC, Barts Heart Centre and William Harvey Research Institute, Queen Mary University of London, Cardiac imaging, 2nd floor Barts Heart Centre. West Smithfield, London EC1A 7BE, UK
| | - Mark Westwood
- Barts Heart Centre, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE, UK
| | - Alexandros Stefanidis
- 1st Department of Cardiology General Hospital of Nikea3 P. Mela str., 184 54, Athens, Greece
| | - Kevin F Fox
- Department of Cardiology, Imperial College Healthcare NHS Trust Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
| | - Bogdan A Popescu
- Cardiology Department, University of Medicine and Pharmacy ‘Carol Davila’-Euroecolab, Institute of Cardiovascular Diseases ‘Prof. Dr. C. C. Iliescu’, Strada Dionisie Lupu 37, Bucharest, Romania
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A decision support system and rule-based algorithm to augment the human interpretation of the 12-lead electrocardiogram. J Electrocardiol 2017; 50:781-786. [DOI: 10.1016/j.jelectrocard.2017.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Indexed: 11/18/2022]
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Affiliation(s)
- Claire A Martin
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - Pier D Lambiase
- Department of Cardiology, Barts Health NHS Trust, London, UK
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Abstract
Management of cardiovascular disease in patients with cancer and cancer survivors requires particular clinical expertise and skills that are central to cardio-oncology. The areas of knowledge required include specific cardiovascular complications directly related to oncologic therapies and the impact of cancer and its therapies on existing or potential cardiovascular comorbidities. Many cancer therapeutics have potential cardiotoxicity. The conversion of many cancers to chronic conditions, rather than fatal diseases, has produced a population of patients with cancer at high risk for cardiovascular diseases that require specialized knowledge of treating physicians. Thus, there is a compelling need for enhanced cardio-oncology training.
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Piepoli MF, Corrà U, Dendale P, Frederix I, Prescott E, Schmid JP, Cupples M, Deaton C, Doherty P, Giannuzzi P, Graham I, Hansen TB, Jennings C, Landmesser U, Marques-Vidal P, Vrints C, Walker D, Bueno H, Fitzsimons D, Pelliccia A. Challenges in secondary prevention after acute myocardial infarction: A call for action. Eur J Cardiovasc Nurs 2017; 16:369-380. [DOI: 10.1177/1474515117702594] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Massimo F Piepoli
- Cardiac Department, Guglielmo da Saliceto Polichirurgico Hospital AUSL Piacenza, Italy
| | - Ugo Corrà
- Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy
| | - Paul Dendale
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Ines Frederix
- Heart Centre Hasselt, University of Hasselt, Belgium
| | - Eva Prescott
- Department of Cardiology, University of Copenhagen, Denmark
| | | | - Margaret Cupples
- Department of General Practice and Primary Care, Queen’s University Belfast, UK
| | - Christi Deaton
- Florence Nightingale Foundation, Cambridge University Hospitals NHS Foundation Trust, UK
| | | | - Pantaleo Giannuzzi
- Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy
| | - Ian Graham
- Trinity College, University of Dublin, Ireland
| | | | | | - Ulf Landmesser
- Department of Cardiology, Charite Universitätsmedizin Berlin, Germany
| | | | | | - David Walker
- Department of Cardiology, East Sussex Healthcare NHS Trust, UK
| | - Hector Bueno
- Cardiology Department, Universidad Complutense de Madrid, Spain
| | | | - Antonio Pelliccia
- Institute of Sport Medicine and Science, Comitato Olimpico Nazionale Italiano, Italy
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Piepoli MF, Corrà U, Dendale P, Frederix I, Prescott E, Schmid JP, Cupples M, Deaton C, Doherty P, Giannuzzi P, Graham I, Hansen TB, Jennings C, Landmesser U, Marques-Vidal P, Vrints C, Walker D, Bueno H, Fitzsimons D, Pelliccia A. Challenges in secondary prevention after acute myocardial infarction: A call for action. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2017; 6:299-310. [PMID: 28608759 DOI: 10.1177/2048872616689773] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Worldwide, each year more than 7 million people experience myocardial infarction, in which one-year mortality rates are now in the range of 10%, but vary with patient characteristics. The consequences are even more dramatic: among patients who survive, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings are endorsed.
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Affiliation(s)
- Massimo F Piepoli
- 1 Cardiac Department, Guglielmo da Saliceto Polichirurgico Hospital AUSL Piacenza, Italy
| | - Ugo Corrà
- 2 Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy
| | - Paul Dendale
- 3 Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Ines Frederix
- 4 Heart Centre Hasselt, University of Hasselt, Belgium
| | - Eva Prescott
- 5 Department of Cardiology, University of Copenhagen, Denmark
| | | | - Margaret Cupples
- 7 Department of General Practice and Primary Care, Queen's University Belfast, UK
| | - Christi Deaton
- 8 Florence Nightingale Foundation, Cambridge University Hospitals NHS Foundation Trust, UK
| | | | - Pantaleo Giannuzzi
- 2 Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy
| | - Ian Graham
- 10 Trinity College, University of Dublin, Ireland
| | | | - Catriona Jennings
- 12 Department of Cardiovascular Medicine, Imperial College London, UK
| | - Ulf Landmesser
- 13 Department of Cardiology, Charite Universitätsmedizin Berlin, Germany
| | - Pedro Marques-Vidal
- 14 Department of Internal Medicine, Lausanne University Hospital, Switzerland
| | | | - David Walker
- 16 Department of Cardiology, East Sussex Healthcare NHS Trust, UK
| | - Hector Bueno
- 17 Cardiology Department, Universidad Complutense de Madrid, Spain
| | | | - Antonio Pelliccia
- 19 Institute of Sport Medicine and Science, Comitato Olimpico Nazionale Italiano, Italy
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Fabris E, Kennedy MW. International Subspecialty Fellowship Training, the Path for Cardiologists of Tomorrow? J Am Coll Cardiol 2017; 69:1200-1203. [DOI: 10.1016/j.jacc.2017.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sinagra G, Fabris E, Tavazzi L. The evolution of cardiology: changes, future challenges and opportunities. Future Cardiol 2017; 13:161-171. [PMID: 28169557 DOI: 10.2217/fca-2016-0050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The field of cardiovascular medicine continues to rapidly evolve in both diagnostic and therapeutic arenas. Subspecialization is required to keep pace with evolving practice; however, a multidisciplinary approach in a framework of cost-benefit care will be equally crucial in the management of increasing numbers of complex patients. Information technology and translational medicine may radically change clinical research and practice. It is important to consider the evolution of medicine and reflect on it in order to set the right course to achieve patient-centered goals. Therefore, we present an overview of this evolving picture, a glimpse into the near future aimed at reflecting on the upcoming changes, challenges and opportunities to improve patient care.
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Affiliation(s)
- Gianfranco Sinagra
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata & Postgraduate School of Cardiology, University of Trieste, Trieste, Italy
| | - Enrico Fabris
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata & Postgraduate School of Cardiology, University of Trieste, Trieste, Italy
| | - Luigi Tavazzi
- GVM Care & Research, E.S. Health Science Foundation, Cotignola, Italy
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Cairns AW, Bond RR, Finlay DD, Breen C, Guldenring D, Gaffney R, Gallagher AG, Peace AJ, Henn P. A computer-human interaction model to improve the diagnostic accuracy and clinical decision-making during 12-lead electrocardiogram interpretation. J Biomed Inform 2016; 64:93-107. [DOI: 10.1016/j.jbi.2016.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/22/2016] [Accepted: 09/25/2016] [Indexed: 01/15/2023]
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Piepoli MF, Corrà U, Dendale P, Frederix I, Prescott E, Schmid JP, Cupples M, Deaton C, Doherty P, Giannuzzi P, Graham I, Hansen TB, Jennings C, Landmesser U, Marques-Vidal P, Vrints C, Walker D, Bueno H, Fitzsimons D, Pelliccia A. Challenges in secondary prevention after acute myocardial infarction: A call for action. Eur J Prev Cardiol 2016; 23:1994-2006. [DOI: 10.1177/2047487316663873] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Massimo F Piepoli
- Cardiac Department, Guglielmo da Saliceto Polichirurgico Hospital AUSL Piacenza, Italy
| | - Ugo Corrà
- Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy
| | - Paul Dendale
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Ines Frederix
- Heart Centre Hasselt, University of Hasselt, Belgium
| | - Eva Prescott
- Department of Cardiology, University of Copenhagen, Denmark
| | | | - Margaret Cupples
- Department of General Practice and Primary Care, Queen’s University Belfast, UK
| | - Christi Deaton
- Florence Nightingale Foundation, Cambridge University Hospitals NHS Foundation Trust, UK
| | | | - Pantaleo Giannuzzi
- Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy
| | - Ian Graham
- Trinity College, University of Dublin, Ireland
| | | | | | - Ulf Landmesser
- Department of Cardiology, Charite Universitätsmedizin Berlin, Germany
| | | | | | - David Walker
- Department of Cardiology, East Sussex Healthcare NHS Trust, UK
| | - Héctor Bueno
- Cardiology Department, Universidad Complutense de Madrid, Spain
| | | | - Antonio Pelliccia
- Institute of Sport Medicine and Science, Comitato Olimpico Nazionale Italiano, Italy
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Sivera F, Ramiro S, Cikes N, Cutolo M, Dougados M, Gossec L, Kvien TK, Lundberg IE, Mandl P, Moorthy A, Panchal S, da Silva JAP, Bijlsma JW. Rheumatology training experience across Europe: analysis of core competences. Arthritis Res Ther 2016; 18:213. [PMID: 27663359 PMCID: PMC5035447 DOI: 10.1186/s13075-016-1114-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 09/06/2016] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. Method An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures. The target population consisted of rheumatology trainees and recently certified rheumatologists across Europe. The relationship between the country of training and the self-reported ability or training methods for each competence was analyzed through linear or logistic regression, as appropriate. Results In total 1079 questionnaires from 41 countries were gathered. Self-reported ability was high for most competences, range 7.5–9.4 (0–10 scale) for clinical competences, 5.8–9.0 for technical procedures and 7.8–8.9 for generic competences. Competences with lower self-reported ability included managing patients with vasculitis, identifying crystals and performing an ultrasound. Between 53 and 91 % of the trainees received formal education and between 7 and 61 % of the trainees reported limited practical experience (managing ≤10 patients) in each competence. Evaluation of each competence was reported by 29–60 % of the respondents. In adjusted multivariable analysis, the country of training was associated with significant differences in self-reported ability for all individual competences. Conclusion Even though self-reported ability is generally high, there are significant differences amongst European countries, including differences in the learning structure and assessment of competences. This suggests that educational outcomes may also differ. Efforts to promote European harmonization in rheumatology training should be encouraged and supported. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1114-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francisca Sivera
- Department Reumatologia, Hospital General Universitario de Elda, ctra Sax s/n, Elda, Alicante, 03600, Spain.
| | - Sofia Ramiro
- Leiden University Medical Center, Leiden, The Netherlands
| | - Nada Cikes
- University of Zagreb School of Medicine, University Hospital Centre, Zagreb, Croatia
| | - Maurizio Cutolo
- Research Laboratories and Academic Division of Clinical Rheumatology, Postgraduate School on Rheumatology, Department of Internal Medicine University of Genova, Genova, Italy
| | - Maxime Dougados
- Université Paris Descartes University, Department of Rheumatology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris; INSERM (U1153): Epidemiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France
| | - Laure Gossec
- Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique; AP-HP, Pitié Salpêtrière Hospital, Department of rheumatology, F-75013, Paris, France
| | - Tore K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid E Lundberg
- Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Sweden.,Karolinska Institutet, Stockholm, Sweden
| | | | | | - Sonia Panchal
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - José A P da Silva
- Centro Hospitalar e Universitário de Coimbra, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
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Organization and implementation of a cardio-oncology program. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Patients hospitalized for acute heart failure (AHF) may clinically decompensate and experience life-threatening complications. Regional differences in intensive care unit (ICU) admission rates have been reported by European registries. Variations regarding ICU bed and facilities availability may contribute to these geographic differences. ICU triage decision requires cautious clinical judgment to balance between clinical benefit of ICU care and associated risk and cost. In Europe, despite large variations in treatment practices, in-hospital mortality of AHF patients managed in ICUs is similar, suggesting that high-risk characteristics of AHF patients admitted to ICUs, rather than geographic variation in intensity of therapies, may be the principal determinant of prognosis.
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Affiliation(s)
- Ovidiu Chioncel
- ICCU and Cardiology 1st Department, Institute of Emergency for Cardiovascular Diseases "C.C.Iliescu", University of Medicine Carol Davila, sos Fundeni, no 258, Bucharest sect 2, Romania.
| | - Alexandre Mebazaa
- Department of Anesthesia and Critical Care, Hôpital Lariboisière, DAR, Hôpitaux Universitaires Saint Louis Lariboisière, APHP, University Paris Diderot, 2 Rue A Paré, Paris Cedex 10 75475, France
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Fiuza M, Ribeiro L, Magalhães A, Sousa AR, Nobre Menezes M, Jorge M, Costa L, Pinto FJ. Organization and implementation of a cardio-oncology program. Rev Port Cardiol 2016; 35:485-94. [PMID: 27503589 DOI: 10.1016/j.repc.2016.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/30/2016] [Accepted: 04/13/2016] [Indexed: 10/21/2022] Open
Abstract
Considerable advances in cancer therapies in recent decades have reshaped the prognosis of cancer patients. There are now estimated to be over 20 million cancer survivors in the USA and Europe, numbers unimaginable a few years ago. However, this increase in survival, along with the aging of the patient population, has been accompanied by a rise in adverse cardiovascular effects, particularly when there is a previous history of heart disease. The incidence of cardiotoxicity continues to grow, which can compromise the effectiveness of cancer therapy. Cardiotoxicity associated with conventional therapies, especially anthracyclines and radiation, is well known, and usually leads to left ventricular dysfunction. However, heart failure represents only a fraction of the cardiotoxicity associated with newer therapies, which have diverse cardiovascular effects. There are few guidelines for early detection, prevention and treatment of cardiotoxicity of cancer treatments, and no well-established tools for screening these patients. Echocardiography is the method of choice for assessment of patients before, during and after cancer treatment. It therefore makes sense to adopt a multidisciplinary approach to these patients, involving cardiologists, oncologists and radiotherapists, collaborating in the development of new training modules, and performing clinical and translational research in a cardio-oncology program. Cardio-oncology is a new frontier in medicine and has emerged as a new medical subspecialty that concentrates knowledge, understanding, training and treatment of cardiovascular comorbidities, risks and complications in patients with cancer in a comprehensive approach to the patient rather than to the disease.
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Affiliation(s)
- Manuela Fiuza
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa / Centro Cardiovascular da Universidade de Lisboa, Lisboa, Portugal.
| | - Leonor Ribeiro
- Serviço de Oncologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa, Lisboa, Portugal
| | - Andreia Magalhães
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa / Centro Cardiovascular da Universidade de Lisboa, Lisboa, Portugal
| | - Ana Rita Sousa
- Serviço de Oncologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa, Lisboa, Portugal
| | - Miguel Nobre Menezes
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa / Centro Cardiovascular da Universidade de Lisboa, Lisboa, Portugal
| | - Marília Jorge
- Serviço de Radioterapia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Lisboa, Portugal
| | - Luís Costa
- Serviço de Oncologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa, Lisboa, Portugal
| | - Fausto José Pinto
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Centro Académico Medicina de Lisboa / Centro Cardiovascular da Universidade de Lisboa, Lisboa, Portugal
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