Target: CAD and Imaging

From "Cardiac magnetic resonance stress test in coronary artery disease"

Learning objectives

Describe the utility of cardiac magnetic resonance stress testing using either adenosine stress first-pass perfusion or dobutamine stress wall motion imaging to predict subsequent cardiac events.

1. In this study to evaluate the prognostic value of cardiac magnetic resonance (CMR) stress testing, the MR imaging results that predicted cardiac events included all but the following:
   
   
   1. Resting wall motion abnormalities
   2. Preserved end-diastolic wall thickness
   3. Left ventricular ejection fraction
   4. Positive results on CMR stress testing
   
   
2. Sequential Cox regression models were used to further examine whether CMR imaging data added to the predictive capabilities of clinical data. During a 3-step modeling procedure, variables were included in the same order as in clinical practice; that is: 1) clinical data; 2) wall motion abnormalities and left ventricular systolic function at rest; and, 3) results of CMR stress testing. With more than 4 cardiac rest factors, the presence of _____ further increased the likelihood of hard cardiac events.
   
   
   1. clinical data
   2. positive CMR stress testing results
   3. wall motion abnormalities at rest
   
   
3. The results of this study showed that _______ in identifying subjects at risk for future cardiac events.
   
   
   1. adenosine stress magnetic resonance perfusion (MRP) was more valuable
   2. dobutamine stress magnetic resonance (DSMR) wall motion imaging was more valuable
   3. MRP and DSMR were equally valuable
   
   
4. Multivariate analysis of the data from this study proved _______ to be the only independent predictor of future cardiac events.
   
   
   1. a positive CMR stress test result
   2. clinical risk factors
   3. wall motion assessment at rest
   
   
5. The predictive power of a negative test result of MRP or DSMR may be considered limited to a _____ "warranty period": event-free survival seemed to be prolonged only in subjects with a normal MRP and DSMR result.
   
   
   1. 18-month
   2. 2-year
   3. 30-month
   4. 3-year
   
   

To take this exam, you can download the CME answer form (PDF) and mail, fax, or email it to address given; or go to the University of Cincinnati's Center for Continuous Professional Development. Cardiology Review materials are posted to that site on a continuous basis (registration required).

Target: Arrhythmias and Hypertension

From "Cardiovascular morbidity in persistent atrial fibrillation in hypertension"

Learning objectives

Describe cardiovascular morbidity and mortality and patient quality of life among hypertensive and normotensive patients with persistent atrial fibrillation, along with the impact of pharmacologic heart rate control versus rhythm control using cardioversion and antiarrhythmic drugs.

1. The risk of stroke is increased ________ in patients with hypertension and atrial fibrillation.
   
   
   1. 2-fold
   2. 2- to 3-fold
   3. 3- to 4-fold
   4. 4- to 5-fold
   
   
2. Fifty-seven percent of hypertensive study subjects and 45% of normotensive subjects were randomly assigned to receive rhythm control treatment. Sinus rhythm was restored in ____ and _____ of the hypertensive and normotensive subjects, respectively.
   
   
   1. 15%; 21%
   2. 25%; 33%
   3. 35%; 41%
   4. 40%; 48%
   
   
3. The occurrence of the primary endpoint in this study was significantly influenced by the randomization treatment in hypertensive subjects but not in normotensive subjects. An endpoint occurred in 31% of the hypertensive subjects randomly assigned to receive rhythm control therapy compared with only 17% of the hypertensive subjects in the rate control arm. This unequal distribution of endpoints was mainly the result of the occurrence of all but which of the following?
   
   
   1. Ventricular arrhythmias
   2. Thromboembolic complications
   3. Severe adverse effects of antiarrhythmia drugs
   4. Severe adverse effects of pacemaker implantations
   
   
4. In accordance with earlier studies, the characteristics of hypertensive subjects differed from normotensive subjects in this study. Hypertensive subjects were distinguished by all but which one of the following characteristics?
   
   
   1. Had higher systolic and diastolic blood pressures
   2. Were more often men c Were older
   3. More often had diabetes mellitus
   
   
5. Despite the high use of oral anticoagulant therapy in the RACE study, the occurrence of more thromboembolic complications in hypertensive subjects (vs normotensive) can be explained by the potent __________ risk associated with hypertension.
   
   
   1. Diabetes mellitus
   2. Myocardial infarction
   3. Stroke
   4. Underlying heart disease
   
   

To take this exam, you can download the CME answer form (PDF) and mail, fax, or email it to address given; or go to the University of Cincinnati's Center for Continuous Professional Development. Cardiology Review materials are posted to that site on a continuous basis (registration required).