Grantham Hospital is a specialist cardiothoracic hospital located at Wong Chuk Hang and is part of the Hong Kong West Cluster. It is a tertiary referral centre providing specialist service in cardiothoracic surgery, cardiology, paediatric cardiology, tuberculosis & chest medicine and cardio-pulmonary infirmary. In 2003 and 2004, palliative medicine and acute geriatrics service were set up respectively after Nam Long Hospital has been closed down in December 2003.The hospital is founded in 1957 by the Hong Kong Tuberculosis, Chest and Heart Diseases Association and renamed for Alexander Grantham, a former Governor of Hong Kong. It has 372 beds and 544 staff.The hospital is affiliated with the Medical faculty of the University of Hong Kong, providing clinical attachment opportunities for its medical students. The University's divisions of cardiothoracic surgery, cardiology and paediatric cardiology have their bases here. However, it has been proposed that these acute services will be relocated to the Queen Mary Hospital (the Flagship teaching hospital of the University) in the coming future for better and more efficient use of resources. Grantham Hospital will then become a hospital dedicated to chronic and palliative care.The School of General Nursing has been re-opened in 2008 to educate and train up Enrolled Nurses and the hospice centre under the Li Ka Shing Foundation Hospice Service Programme was set up to provide holistic care to cancer patients and their families..
BACKGROUND:SESAME (septal scoring along the midline endocardium) is a novel transcatheter electrosurgical technique for septal reduction. Experience with this technique in the Asia-Pacific region has not been previously described. CASE SUMMARY:We report 4 cases of SESAME procedures performed in the Asia-Pacific region. The procedures encompassed diverse clinical scenarios, including standalone treatment for hypertrophic obstructive cardiomyopathy (HOCM) in patients with persistent symptoms despite prior alcohol septal ablation or lack of suitable septal branches, and as an adjunct to transcatheter aortic valve replacement (TAVR) in patients with concomitant severe aortic stenosis and septal hypertrophy. The procedures were successfully completed in all cases with reduction in left ventricular outflow tract (LVOT) gradients. One patient developed high-grade atrioventricular block requiring permanent pacemaker implantation. At follow-up ranging from 1 to 3 months, patients demonstrated improved LVOT gradients and functional status. TAKE-HOME MESSAGES:This case series demonstrates the feasibility of SESAME in the Asia-Pacific region for various indications including standalone HOCM treatment and prevention of LVOT obstruction in conjunction with TAVR. Further multicenter studies are needed to evaluate the long-term outcomes and safety profile of this emerging technique in diverse patient populations.
Abstract Background Heart failure (HF) is a significant global health challenge due to its high mortality and re-hospitalisation rates. To address the complexities of HF, international guidelines recommend a multidisciplinary team management and collaborative care (Class IA). Data on advanced HF (AdvHF) multidisciplinary management program being led by HF specialty-trained nurses and collaboration with various specialists across boundaries remain scarce due to perceived higher risks and intensity of care required to be delivered. Purpose We evaluated the safety and efficacy of a multidisciplinary AdvHF program which were individualised for AdvHF patients (pts) being referred to our AdvHF centre. Methods The program included comprehensive baseline evaluations, namely echocardiogram, 6-minutes-walk test (6MWT), NTproBNP levels, Kansas City Cardiomyopathy Questionnaire (KCCQ), Frailty score, HF-associated hospitalisation (HFH). AdvHF pts underwent intensive monitoring and medications titration, together with supervised, centre-based exercise training, with additional health education on lifestyle changes, dietary counselling, training for activities of daily living, and stress management, all provided by a multidisciplinary team being led by HF nurse specialists and HF cardiologists, with physiotherapists, dietitians, occupational therapists and clinical psychologists. Retrospective evaluations of the program were conducted to assess the health outcomes of the participants, by comparing 1 year before enrollment and 1 year post program. Results A total of 103 advanced HF pts with mean LVEF 25.8±8.8% were enrolled and completed program from September 2021 to August 2025. Mean age was 53.5±10.5 years old (78% male; 28% ischemic cardiomyopathy). Analysis of the post-program evaluations revealed significant improvements across several key health measures. 6MWT distances was increased by 8.5% (p<0.001), LVEF increased by 43.3% (25.8±8.8% vs. 37.0±12.0%), NT-proBNP level decreased by 38.8% (p<0.001). Quality of life, as measured by KCCQ showed a 12.1% improvement (p<0.001), while the frailty score decreased by 38.8% (p<0.01), suggesting enhanced physical resilience and improved overall well-being. Lastly, heart failure-related hospitalizations declined by 87.9% (p<0.001) following program completion. Conclusion Multidisciplinary approach with effective collaboration for AdvHF patients has led to significant enhancements in clinical outcomes, exercise capacity, quality of life, and reductions in HF hospitalisations. Such integrated, tailor-made, cross boundaries collaboration AdvHF program should be implemented with anticipated improved clinical outcomes and reduced healthcare burden and costs.For image description, please refer to the figure legend and surrounding text.
Abstract Background Heart failure with reduced ejection fraction (HFrEF) is a significant public health challenge characterized by poor prognosis and frequent hospitalisations. The foundational quadruple therapy for HFrEF has been shown to improve survival, quality of life, and reduce HF-related hospitalisations when titrated to target doses. The STRONG-HF study demonstrated that accelerated dose titration with intense follow-up improved clinical outcomes. However, up-titration to target doses remains suboptimal due to barriers like drug non-adherence, knowledge gaps in optimisation strategies, and physician inertia. In October 2023, a Pharmacist-led Heart Failure Clinic (PHFC), in close collaboration with HF physicians and nurse specialists, was established at Grantham Hospital, a tertiary referral center for advanced HF in Hong Kong. Purpose This retrospective single-group pre-post study evaluated the effectiveness of pharmacist intervention on outcomes of our cohort of HF patients. The study assessed changes in 1) proportion of patients achieving ≥50% target dose of Guideline-Directed Medical Therapy (GDMT), 2) percentage of patients with dose titration to target dose, 3) number of HF-related hospitalisations and 4) plasma NT-proBNP levels. Methods Patients were enrolled in the PHFC by referrals from physicians between October 2023 and November 2025. The clinic followed a management protocol jointly developed by advanced HF physicians and pharmacists. GDMT doses were compared at baseline and up to 1 year post-enrolment, classified into <50% and ≥50% of target dose. The number of HF-related hospitalisations was compared 1 year before and after enrollment. NT-proBNP levels were compared at enrolment and up to 1 year post-enrollment, if available. Results A total of 207 patients were enrolled in the PHFC. Most patients were on SGLT2i as tolerated with counselling provided. For the rest of the 3 GDMT drugs: the proportion of patients achieving ≥50% of target doses significantly increased from 47.3% to 78.3% for Sacubitril/Valsartan, 29.2% to 47.4% for Beta-blockers and 68.0% to 80.6% for Mineralocorticoid Receptor Antagonists (MRA) (Figure 1). Additionally, the clinic successfully titrated a number of patients to target doses (Table 1a). Among the 114 patients (55%) followed up for more than 1 year, HF-related hospitalisations decreased significantly by 78.8% (p <0.001; Table 1b). Forty patients (19%) had NT-proBNP levels measured near the time of enrolment and up to 1 year post enrolment, revealing a significant reduction by 32.0% (p <0.05; Table 1b). Conclusion The PHFC for HF patients led by pharmacists represents a promising and feasible approach. This study shows that accelerated medication titration can be safe and effective for HF patients, even those considered "drug refractory". Incorporating pharmacists into the multidisciplinary care team enhances patient outcomes through proactive medication management and monitoring.Figure 1, Table 1a, Table 1bFor image description, please refer to the figure legend and surrounding text.
Hypertrophic cardiomyopathy (HCM) patients have an increased risk of heart failure (HF), arrhythmias and sudden cardiac death (SCD). There are a lack of studies comparing the prognostic value of cardiac magnetic resonance (CMR) determined left ventricular (LV) global longitudinal strain (LVGLS), left atrial strain (LAS), and late gadolinium enhancement (LGE). This retrospective study aims to identify the significant independent predictor(s) of MACE in patients with HCM. HCM patients who underwent CMR examinations between 2008 and 2022 at 5 medical sites were recruited. CMR feature-tracking (FT) was used to determine LV strain (LVS) and LAS. LGE was quantified. Primary outcome was a composite outcome of MACE (i.e., HF hospitalisation, cardiac arrest and all-cause mortality). Univariate and multivariate Cox regression analyses included clinical parameters, HCM features, medications, LVS, LAS and LGE. Kaplan–Meier analyses with log-rank tests were performed. 468 patients (308 males, median age of 64) were included. 147 patients experienced MACE with a median follow-up of 7.6 years. Patients with MACE had smaller LVGLS (− 8.03
PURPOSE:To evaluate the corneal biomechanical and biometric properties in immunoglobulin G4-related ophthalmic disease (IgG4-ROD) patients. SETTING:Ethnic Han Chinese biopsy-proven IgG4-ROD patients from a territory wide cohort and sex-, age-, smoking- and lens status-matched healthy controls. DESIGN:A case-controlled (1:1) study. METHODS:Corvis ST analyzer and IOL Master 700 biometry assessment. RESULTS:Sixty-seven eyes from 67 patients with IgG4-ROD (41 = males), aged 63.9 ± 13.1 years and 67 right eyes from 67 healthy ethnically Han Chinese controls were recruited. IgG4-ROD eyes were associated with a more negative applanation 2 velocity (-0.30 versus -0.27 m/s, P = 0.0143), and reduced radius of curvature (7.48 versus 7.98 mm, P = 0.0136). There was no difference in intraocular pressure, applanation 1 length, applanation 1 velocity, applanation 2 length, deformation amplitude and peak distance. Corneal astigmatism was greater in IgG4-ROD eyes (-1.2 versus -0.9 D, P = 0.0132), and the deep axis is along 90.2 degree. There is no difference in the steep and flat keratometry, deep axis, lens thickness, cornea thickness, and anterior chamber depth. CONCLUSIONS:We found multiple corneal changes in biomechanics and fine structures in a cohort of biopsy-proven IgG4-ROD with potential long-term implications in ocular surface functions. A longitudinal follow-up would be useful to identify the clinical implications and observe if these changes improve with treatments.
