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Paratz ED, Stub D, Sutherland N, Gutman S, La Gerche A, Mariani J, Taylor A, Ellims A. Response to: Regard to assessing agreement between two raters with kappa statistics. Int J Cardiol 2024; 404:131978. [PMID: 38513734 DOI: 10.1016/j.ijcard.2024.131978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Elizabeth D Paratz
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC 3108, Australia.
| | - Dion Stub
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC 3108, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia
| | | | - Sarah Gutman
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
| | - Andre La Gerche
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia
| | - Justin Mariani
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
| | - Andrew Taylor
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
| | - Andris Ellims
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
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Warren J, Ellims A, Bloom J, Sutherland N, Lew P, Kavnoudias H, Paleri S, Stub D, Taylor A. Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals. Open Heart 2024; 11:e002609. [PMID: 38458771 DOI: 10.1136/openhrt-2024-002609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE Coronary CT angiography (CCTA) permits both qualitative and quantitative analysis of atherosclerotic plaque and may be a suitable risk modifier in assessing patients at intermediate risk of atherosclerotic cardiovascular disease. We sought to determine the association of plaque components with long-term major adverse cardiovascular events (MACEs) in asymptomatic intermediate-risk patients, compared with conventional coronary artery calcium (CAC) score. METHODS 100 intermediate-risk patients underwent double-blinded CCTA. Follow-up was conducted at 10 years and data were cross-referenced with the National Death Index. The primary outcome was MACE, which was a composite of death, acute coronary syndrome (ACS), revascularisation and stroke. RESULTS The median time from CCTA to follow-up was 9.5 years. 83 patients completed follow-up interview and mortality data were available on all 100 patients. MACE occurred in 17 (20.5%) patients, which included 2 (2%) deaths, 8 (10%) ACS, 3 (4%) strokes and 5 (6%) revascularisation procedures. 47 (57%) patients had mixed plaque, which was predictive of MACE (OR 4.68 (95% CI 1.19 to 18.5) p=0.028). The burden of non-calcified and mixed plaque, defined by non-calcified plaque segment stenosis score, was also a predictor of long-term MACE (OR 1.59 (95% CI 1.18 to 2.13) p=0.002). Neither calcified plaque (OR 3.92 (95% CI 0.80 to 19.3)) nor CAC score (OR 1.01 (95% CI 0.999 to 1.02)) was associated with long-term MACE. CONCLUSION The presence and burden of mixed plaque on CCTA is associated with an increased risk of long-term MACE among asymptomatic intermediate-risk patients and is a superior predictor to CAC score.
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Affiliation(s)
- Josephine Warren
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Andris Ellims
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jason Bloom
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Nigel Sutherland
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Philip Lew
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Helen Kavnoudias
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neuroscience and Surgery, Monash University, Clayton, Victoria, Australia
| | - Sarang Paleri
- Department of Cardiology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Dion Stub
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Andrew Taylor
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
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Paratz ED, Stub D, Sutherland N, Gutman S, La Gerche A, Mariani J, Taylor A, Ellims A. The challenge of risk stratification in hypertrophic cardiomyopathy: Clinical, genetic and imaging insights from a quaternary referral centre. Int J Cardiol 2024; 395:131416. [PMID: 37802298 DOI: 10.1016/j.ijcard.2023.131416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is the commonest genetic cardiomyopathy and may result in sudden cardiac death (SCD). Clinical risk stratification scores are utilised to estimate SCD risk and determine potential utility of a primary prevention implantable cardioverter defibrillator (ICD). METHODS Patients with a confirmed diagnosis of HCM from a quaternary HCM service were defined according to clinical characteristics, genetic profiles and cardiac imaging results. European Risk-SCD score and American Heart Association / American College of Cardiology (AHA/ACC) Score were calculated. The primary outcome was cardiac arrest. RESULTS 380 patients with HCM were followed up for a median of 6.4 years. 18 patients (4.7%) experienced cardiac arrest, with predictive factors being younger age (37.2 vs 54.4 years, p = 0.0041), unexplained syncope (33.3% vs 9.4%, p = 0.007), non-sustained ventricular tachycardia (50.0% vs 12.7%, p < 0.0001), increased septal thickness (21.5 vs 17.5 mm, p = 0.0003), and presence of a sarcomeric gene mutation (100.0% vs 65.8%, p = 0.038). The Risk-SCD and AHA/ACC scores had poor agreement (kappa coefficient 0.38). Risk-SCD score had poor sensitivity (44.4%), classifying 55.6% of patients with cardiac arrest as low-risk but was highly specific (93.7%). AHA/ACC risk score did not discriminate between groups significantly. 20 patients (5.3%) died, with most >60-year-olds having a non-cardiac cause of death (p = 0.0223). CONCLUSION This study highlights limited (38%) agreement between the Risk-SCD and AHA/ACC scores. Most cardiac arrests occurred in ostensibly low or medium-risk patients under both scores. Appropriate ICD selection remains challenging. Incorporating newer risk markers such as HCM genotyping and myocardial fibrosis quantification by cardiac MRI may assist future risk refinement.
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Affiliation(s)
- Elizabeth D Paratz
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC 3108, Australia.
| | - Dion Stub
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC 3108, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia
| | | | - Sarah Gutman
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
| | - Andre La Gerche
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC 3065, Australia
| | - Justin Mariani
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
| | - Andrew Taylor
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
| | - Andris Ellims
- Alfred Hospital, 55 Commercial Rd, Prahran, VIC 3181, Australia
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Sutherland N, Sivaratnam D, Pearson M, Better N. Use of SPECT imaging to confirm ATTR cardiac amyloid in a Tc99m pyrophosphate study artefactually compromised by a recent V/Q scan. J Nucl Cardiol 2023; 30:2242-2244. [PMID: 36609985 DOI: 10.1007/s12350-022-03163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Nigel Sutherland
- Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, Australia.
| | - Dinesh Sivaratnam
- Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Nuclear Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Nuclear Medicine, St Frances Xavier Cabrini Hospital, Malvern, VIC, Australia
| | - Michael Pearson
- Department of Nuclear Medicine, St Frances Xavier Cabrini Hospital, Malvern, VIC, Australia
| | - Nathan Better
- Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Nuclear Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Nuclear Medicine, St Frances Xavier Cabrini Hospital, Malvern, VIC, Australia
- Department of Cardiology, St Frances Xavier Cabrini Hospital, Suite 50, Isabella St, Malvern, VIC, 3144, Australia
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Cameron J, Sutherland N, Han HC, Raman J, Lim H. Ventricular arrhythmias and sudden cardiac death caused by mitral valve prolapse: should we operate and when? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Several autopsy and observational studies have investigated the link between mitral valve prolapse (MVP) and sudden cardiac death (SCD) due to the well accepted yet rare occurrence of complex ventricular arrhythmia (VA) in this cohort. Few studies however have investigated whether arrhythmia burden and more importantly SCD are reduced following surgical correction of MVP.
Purpose
To investigate the impact of mitral valve surgery (MVS) (replacement or repair) on VA and SCD in patients with MVP.
Methods
A systematic review of the current literature was conducted using an electronic search of the PubMed database in October 2021. Studies were included if subjects had undergone mitral valve (MV) repair or replacement with documented rates of arrythmias/SCD pre- and post-intervention. Small patient numbers in individual reports precluded formal meta-analysis and results were reported on a per study basis.
Results
19 identified studies (10 cohort studies, nine case studies) comprised 1322 patients with a pooled mean age of 63.4 years and 38.9% were female. 748 of the 1322 patients underwent MVS: 263 MV repair, 18 MV replacement (one with leaflet and papillary muscle excision), two MV repair with Maze procedure, 177 percutaneous transcatheter MV repair, 45 annuloplasty with or without valve repair, and in 243 cases the surgical method was not specified.
Of the 10 included cohort studies, seven of the eight which investigated rates of VA post MVS concluded there was a significant reduction, while one reported the predisposition to arrythmia persisted after relieving the abnormal mechanical effects of non-ischaemic MR (75% due to MVP). One study reported a reduction in SCD post MVS. Each of the nine included case studies showed a reduction in VA post MVS. One study showed mitral annular disjunction (MAD) was independently associated with a higher risk of arrhythmic events, this link persisting with time dependent MVS although reduced compared to medical management.
Conclusions
The underlying mechanisms for VA and SCD associated with MVP are not completely understood, and guidelines for the surgical correction of MVP based on arrhythmic and SCD risk are lacking. This systematic review illustrates a possible reduction in VA following MVS. Further identification of patients at risk of SCD, and potential use of risk stratification algorithms, would allow for consideration of earlier management and appropriate use of implantable cardioverter-defibrillators (ICD) placement / MVS with an expected survival benefit.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Cameron
- Austin Hospital, Cardiology , Melbourne , Australia
| | - N Sutherland
- Northern Health, Cardiology , Melbourne , Australia
| | - H C Han
- Austin Hospital, Cardiology , Melbourne , Australia
| | - J Raman
- University of Melbourne, Medicine , Melbourne , Australia
| | - H Lim
- University of Melbourne, Medicine , Melbourne , Australia
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Cameron JN, Comella A, Sutherland N, Brown AJ, Phan TG. Non-hyperaemic assessment of coronary ischaemia: application of machine learning techniques. Eur Heart J Digit Health 2022; 3:505-515. [PMID: 36710902 PMCID: PMC9779890 DOI: 10.1093/ehjdh/ztac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/24/2022] [Indexed: 02/01/2023]
Abstract
Aims Hyperaemic and non-hyperaemic pressure ratios (NHPR) are routinely used to identify significant coronary lesions. Machine learning (ML) techniques may help better understand these indices and guide future practice. This study assessed the ability of a purpose-built ML algorithm to classify coronary ischaemia during non-hyperaemia compared with the existing gold-standard technique (fractional flow reserve, FFR). Further, it investigated whether ML could identify components of coronary and aortic pressure cycles indicative of ischaemia. Methods and results Seventy-seven coronary vessel lesions (39 FFR defined ischaemia, 53 patients) with proximal and distal non-hyperaemic pressure waveforms and FFR values were assessed using supervised and unsupervised learning techniques in combination with principal component analysis (PCA). Fractional flow reserve measurements were obtained from the right coronary artery (13), left anterior descending (46), left circumflex (11), left main (1), obtuse marginal (2), and diagonal (4). The most accurate supervised learning classification utilized whole-cycle aortic with diastolic distal blood pressure waveforms, yielding a classification accuracy of 86.9% (sensitivity 86.8%, specificity 87.2%, positive predictive value 86.8%, negative predictive value 87.2%). Principal component analysis showed subtle variations in coronary pressures at the start of diastole have significant relation to ischaemia, and whole-cycle aortic pressure data are important for determining ischaemia. Conclusions Our ML algorithm classifies significant coronary lesions with accuracy similar to previous studies comparing time-domain NHPRs with FFR. Further, it has identified characteristics of pressure waveforms that relate to function. These results provide an application of ML to ischaemia requiring only standard data from non-hyperaemic pressure measurements.
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Affiliation(s)
| | | | - Nigel Sutherland
- Department of Cardiology, Northern Hospital Melbourne, 185 Cooper St, Epping, VIC 3076, Australia
| | - Adam J Brown
- Monash Cardiovascular Research Centre, MonashHeart, Monash Health, Melbourne 3168, Australia
| | - Thanh G Phan
- Department of Neurology, Monash Health and School of Clinical Sciences at Monash Health, Monash University, Melbourne 3168, Australia
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Thondapu V, Sutherland N, Ford T, Claessen B, Dangas GD, Barlis P. Bioresorbable‐polymer Everolimus‐eluting Stents. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Abstract
A woman in her 50s with a background of chronic obstructive pulmonary disease secondary to smoking presented with intermittent chest tightness, dyspnoea and vomiting for 4 days. A presumed diagnosis of acute coronary syndrome (ACS) was made based on dynamic ischaemic ECG changes and elevation in high-sensitivity cardiac troponin T levels. She underwent emergent coronary angiography which demonstrated mild coronary artery disease with left ventriculography suggestive of mid-wall variant Takotsubo cardiomyopathy. Thyroid function tests performed to investigate sinus tachycardia were consistent with hyperthyroidism, and her thyroid-stimulating hormone receptor antibody was elevated. A diagnosis of thyroid storm was made in the setting of a newly diagnosed Graves’ disease and the patient was subsequently commenced on guideline-based therapy. This case demonstrates that Takotsubo cardiomyopathy, a mimic of ACS, is a possible complication of thyroid storm and therefore hyperthyroidism should be considered in the list of differentials in patients presenting with Takotsubo cardiomyopathy.
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Affiliation(s)
- Robin Wj Sia
- General Medicine, Northern Hospital Epping, Epping, Victoria, Australia
| | - Nigel Sutherland
- Cardiology, Northern Hospital Epping, Epping, Victoria, Australia
| | - Chiew Wong
- Cardiology, Northern Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Naveen Sharma
- Cardiology, Northern Hospital Epping, Epping, Victoria, Australia
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Sutherland N, Dayawansa N, Filipopoulos B, Vasanthakumar S, Narayan O, Ponnuthurai FA, van Gaal W. Letter to the Editor: Acute Coronary Syndrome Trends and COVID-19 Waves (Response to the Letter of Čulić et al.). Heart Lung Circ 2022; 31:e34-e35. [PMID: 35033431 PMCID: PMC8754509 DOI: 10.1016/j.hlc.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nigel Sutherland
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia.
| | - Nalin Dayawansa
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia
| | | | | | - Om Narayan
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia
| | | | - William van Gaal
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia; Department of Medicine, University of Melbourne, Melbourne, Vic, Australia
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Sutherland N, Dayawansa NH, Filipopoulos B, Vasanthakumar S, Narayan O, Ponnuthurai FA, van Gaal W. Acute Coronary Syndrome in the COVID-19 Pandemic: Reduced Cases and Increased Ischaemic Time. Heart Lung Circ 2022; 31:69-76. [PMID: 34452843 PMCID: PMC8384488 DOI: 10.1016/j.hlc.2021.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/15/2021] [Accepted: 07/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic has led to unprecedented stress on health care systems, and has affected acute coronary syndrome treatment at every step. This study aimed to examine the impact of COVID-19 on patient presentations with acute coronary syndromes during the first and second pandemic wave in Melbourne, Victoria. METHOD A retrospective cohort study of adults presenting with cute coronary syndrome during the first pandemic wave from 1 March 2020 to 31 April 2020 and the second pandemic wave from 1 July 2020 to 31 August 2020 was compared to a control period from 1 March to 31 April 2019 at a single sub-tertiary referral centre in Melbourne, Victoria servicing a catchment area with a relatively high incidence of COVID-19 cases. RESULTS Three-hundred-and-thirty-five (335) patients were hospitalised with acute coronary syndromes across all three time periods. The total number of patients presenting with an acute coronary syndrome was reduced during the pandemic, with a higher proportion of ST elevation myocardial infarctions. Ischaemic times increased with time from symptom onset to first medical contact rising from 191 minutes in the control period to 292 minutes in the first wave (p=0.06) and 271 minutes in the second wave (p=0.06). Coronary angiography with subsequent revascularisation significantly increased from 55% in the control period undergoing revascularisation to 69% in the first wave (p<0.001) and 74% in the second wave (p<0.001). CONCLUSION A concerning reduction in acute coronary presentations occurred during the COVID-19 pandemic, associated with longer ischaemic times and a higher proportion requiring revascularisation. It is crucial that public awareness campaigns are instituted to address the contributing patient factors in future waves.
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Affiliation(s)
- Nigel Sutherland
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia.
| | - Nalin H Dayawansa
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia
| | | | | | - Om Narayan
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia
| | | | - William van Gaal
- Department of Cardiology, Northern Health, Melbourne, Vic, Australia; Department of Medicine, University of Melbourne, Melbourne, Vic, Australia
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Sutherland N, Dayawansa N, Filipopoulos B, Vasanthakumar S, Narayan O, Ponnuthurai F, van Gaal W. Reduced Presentations and Increased Ischaemic Times for Patients With Acute Coronary Syndromes During the COVID-19 Pandemic. Heart Lung Circ 2021. [PMCID: PMC8324092 DOI: 10.1016/j.hlc.2021.06.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Dayawansa N, Sutherland N, Nandal S, Wong C. A Not Quite Right Ventricle. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Chow C, Sutherland N, Lim H, Mohamed U. Wound Haematoma and Use of Hydrogen Peroxide, Antiplatelets and Anticoagulation Following Cardiac Implantable Electronic Devices. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Chow C, Sutherland N, Lim H, Mohamed U. Procedural Logistics of Physiological (His-bundle or Left Septal) Pacing. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Nandal S, Sutherland N, Dayawansa N, Van Gaal W. 528 Patient Outcomes Post Medical Emergency Team Calls and User Compliance of Track and Trigger Based Observation and Response Chart in Cardiology Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Sutherland N, Khattak Z, Octavia Y, Nandal S, Asrar ul Haq M. 428 Utility of Echocardiography in the Real-World Management of Pulmonary Embolism. A Single Centre Experience of Pulmonary Embolism. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Nandal S, Dayawansa N, Sutherland N, Van Gaal W. 513 Medication Errors Evaluation in the Cardiology Department in a Tertiary Hospital. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sutherland N, Li Wai Suen CFD, Mills C, Lokan J, Sinclair M. Fibrosing Cholestatic Hepatitis-Like Syndrome in an Immunocompetent Patient With an Acute Flare of Chronic Hepatitis B. Hepatology 2019; 70:1480-1483. [PMID: 31077603 DOI: 10.1002/hep.30763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 05/08/2019] [Indexed: 12/07/2022]
Affiliation(s)
- Nigel Sutherland
- Department of Medicine, Gastroenterology and Hepatology, Austin Health, Victoria, Australia
| | | | - Christopher Mills
- Department of Medicine, Gastroenterology and Hepatology, Austin Health, Victoria, Australia
| | - Julie Lokan
- Department of Pathology, Austin Health, Victoria, Australia
| | - Marie Sinclair
- Department of Medicine, Gastroenterology and Hepatology, Austin Health, Victoria, Australia.,Liver Transplant Unit, University of Melbourne, Victoria, Australia
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Vlachadis Castles A, Sutherland N, van Gaal W. Australian Trends in the Insertion of Implantable Loop Recorders 2004–2016. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Castles AV, Sutherland N, Van Gaal W. Prescription Rates of Sacubitril/Valsartan with Government Subsidisation: The Australian Experience. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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O’Brien J, Sutherland N, Meher-Homji Z, Jones E, Chua K. Acute Pericarditis: A Rare Complication of Plasmodium Falciparum Malaria. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Abstract
BACKGROUND The Fontan procedure, the last of a series of operations performed in patients with congenital heart defects, offers improved exercise capacity compared to baseline function but is still reduced compared to healthy peers. Exercise training may improve exercise tolerance but there is no consensus on the safety of this practice or the optimal training regimen. We performed a systematic literature review on the effects of exercise training in patients with a Fontan circulation. METHODS Medline and Embase databases were systematically searched for articles regarding Fontan Procedure and cardiac rehabilitation. RESULTS A total of 23 articles met all inclusion criteria; in total, 201 Fontan subjects were included. Characteristics of the exercise training programs varied significantly. There were no adverse effects related to training programs reported in the literature. Most studies reported benefit across various exercise parameters related to exercise tolerance. CONCLUSIONS Exercise training is safe and beneficial in patients with a Fontan circulation. Exercise training should become a standard of care within this population. Physiological adaptation following exercise training needs to be investigated more extensively.
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Affiliation(s)
- Nigel Sutherland
- Cardiac Surgery Department, Royal Children's Hospital, Melbourne, Vic, Australia
| | - Bryn Jones
- Murdoch Childrens Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, Faculty of Medicine, The University of Melbourne, Melbourne, Vic, Australia; Department of Cardiology, The Royal Children's Hospital, Melbourne, Vic, Australia
| | - Yves d'Udekem
- Cardiac Surgery Department, Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Childrens Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, Faculty of Medicine, The University of Melbourne, Melbourne, Vic, Australia.
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23
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Lin S, Ross T, Sutherland N, Orenstein G. P01.05. Increase in blood flow associated with traditional chinese medicine therapies. BMC Complement Altern Med 2012. [PMCID: PMC3373949 DOI: 10.1186/1472-6882-12-s1-p5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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24
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Kodama AM, Hokama Y, Yasumoto T, Fukui M, Manea SJ, Sutherland N. Clinical and laboratory findings implicating palytoxin as cause of ciguatera poisoning due to Decapterus macrosoma (mackerel). Toxicon 1989; 27:1051-3. [PMID: 2572075 DOI: 10.1016/0041-0101(89)90156-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A near fatal case of ciguatera-related intoxication following consumption of smoked Decapterus macrosoma is documented. In addition to some of the hallmark symptoms of ciguatera poisoning, the patient exhibited acute respiratory distress and severe muscle spasms. Laboratory results showed large elevations in a number of blood enzymes, indicative of muscle damage. The responsible agent was extracted from corresponding fish samples and identified as palytoxin.
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Affiliation(s)
- A M Kodama
- School of Public Health, University of Hawaii, Honolulu
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25
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Malik SK, Olivero J, Sutherland N. Pulmonary edema and oral ingestion of methadone. JAMA 1972; 221:915. [PMID: 5068182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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26
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Sutherland N. "To create a strong and healthy race": school children in the public health movement, 1880-1914. Hist Educ Q 1972; 12:304-333. [PMID: 11614580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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27
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Posey J, Geddes LA, Knight W, Sutherland N. Indirect determination of the rate of rise of arterial pressure. Cardiovasc Res Cent Bull 1968; 7:71-8. [PMID: 5743492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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