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Circulation

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https://www.readbyqxmd.com/read/29352073/right-ventricular-myofilament-functional-differences-in-humans-with-systemic-sclerosis-associated-versus-idiopathic-pulmonary-arterial-hypertension
#1
Steven Hsu, Kristen M Kokkonen-Simon, Jonathan A Kirk, Todd M Kolb, Rachel L Damico, Stephen C Mathai, Monica Mukherjee, Ami A Shah, Fredrick M Wigley, Kenneth B Margulies, Paul M Hassoun, Marc K Halushka, Ryan J Tedford, David A Kass
Background -Patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) have a far worse prognosis than those with idiopathic PAH (IPAH). In the intact heart, SSc-PAH exhibits depressed rest and reserve right ventricular (RV) contractility as compared to IPAH. We tested whether this disparity involves underlying differences in myofilament function. Methods -Cardiac myocytes were isolated from RV septal endomyocardial biopsies from patients with SSc-PAH, IPAH, or SSc with exertional dyspnea but no resting PAH (SSc-d); control RV septal tissue was obtained from non-diseased donor hearts (6-7/group)...
January 19, 2018: Circulation
https://www.readbyqxmd.com/read/29352072/sex-and-race-differences-in-lifetime-risk-of-heart-failure-with-preserved-ejection-fraction-and-heart-failure-with-reduced-ejection-fraction
#2
Ambarish Pandey, Wally Omar, Colby Ayers, Michael LaMonte, Liviu Klein, Norrina Allen, Lewis H Kuller, Philip Greenland, Charles Eaton, John S Gottdiener, Donald Lloyd-Jones, Jarett D Berry
Background -Lifetime risk of heart failure has been estimated to range from 20% to 46% in diverse sex and race groups. However, lifetime risk estimates for the two HF phenotypes, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), is not known. Methods -Participant-level data from 2 large prospective cohort studies, the Cardiovascular Health Study (CHS) and the Multiethnic Study of Atherosclerosis (MESA), were pooled excluding individuals with prevalent HF at baseline...
January 19, 2018: Circulation
https://www.readbyqxmd.com/read/29352071/worsening-renal-function-in-acute-heart-failure-patients-undergoing-aggressive-diuresis-is-not-associated-with-tubular-injury
#3
Tariq Ahmad, Keyanna Jackson, Veena S Rao, W H Wilson Tang, Meredith A Brisco-Bacik, Horng H Chen, G Michael Felker, Adrian F Hernandez, Christopher M O'Connor, Venkata S Sabbisetti, Joseph V Bonventre, F Perry Wilson, Steven G Coca, Jeffrey M Testani
Background -Worsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure (AHF) treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injury biomarkers-NAG, NGAL, and KIM-1- are now available that can quantify the degree of renal tubularinjury. The ROSE-AHF trial provides an experimental platform for the study of mechanisms of WRF during aggressive diuresis for AHF, as the ROSE-AHF protocol dictated high dose loop diuretic therapy in all patients...
January 19, 2018: Circulation
https://www.readbyqxmd.com/read/29348263/phosphoinositide-3-kinase-gamma-inhibition-protects-from-anthracycline-cardiotoxicity-and-reduces-tumor-growth
#4
Mingchuan Li, Valentina Sala, Maria Chiara De Santis, James Cimino, Paola Cappello, Nicola Pianca, Anna Di Bona, Jean Piero Margaria, Miriam Martini, Edoardo Lazzarini, Flora Pirozzi, Luca Rossi, Irene Franco, Julia Bornbaum, Jacqueline Heger, Susanne Rohrbach, Alessia Perino, Carlo G Tocchetti, Braulio H F Lima, Mauro M Teixeira, Paolo E Porporato, Rainer Schulz, Annalisa Angelini, Marco Sandri, Pietro Ameri, Sebastiano Sciarretta, Roberto César P Lima-Júnior, Marco Mongillo, Tania Zaglia, Fulvio Morello, Francesco Novelli, Emilio Hirsch, Alessandra Ghigo
Background -Anthracyclines, such as doxorubicin (DOX), are potent anti-cancer agents for the treatment of solid tumors and hematological malignancies. However, their clinical use is hampered by cardiotoxicity. This study sought to investigate the role of PI3Kγ in DOX-induced cardiotoxicity and the potential cardio-protective and anti-cancer effects of PI3Kγ inhibition. Methods -Mice expressing a kinase-inactive PI3Kγ or receiving PI3Kγ selective inhibitors were subjected to chronic DOX treatment. Cardiac function was analyzed by echocardiography and DOX-mediated signaling was assessed in whole hearts or in isolated cardiomyocytes...
January 18, 2018: Circulation
https://www.readbyqxmd.com/read/29348262/dawn-of-a-new-era-for-stroke-treatment-implications-of-the-dawn-study-for-acute-stroke-care-and-stroke-systems-of-care
#5
Mark J Alberts, Martin D Ollenschleger, Amre Nouh
Until recently, the selection of patients with large artery occlusion and ischemic stroke for reperfusion therapy was based on time criteria (typically within 6 hours) and basic imaging protocols (head CT, CT angiogram, ASPECTS score). The recently published DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo) study has changed this paradigm by using a tissue-based selection criteria and a greatly expanded treatment time window (up to 24 hours)...
January 18, 2018: Circulation
https://www.readbyqxmd.com/read/29348261/complement-receptor-c5ar1-plays-an-evolutionarily-conserved-role-in-successful-cardiac-regeneration
#6
Niranjana Natarajan, Yamen Abbas, Donald M Bryant, Juan Manuel Gonzalez-Rosa, Michka Sharpe, Aysu Uygur, Lucas H Cocco-Delgado, Nhi Ngoc Ho, Norma P Gerard, Craig J Gerard, Calum A Macrae, Caroline E Burns, C Geoffrey Burns, Jessica L Whited, Richard T Lee
Background -Defining conserved molecular pathways in animal models of successful cardiac regeneration could yield insight into why adult mammals have inadequate cardiac regeneration after injury. Insight into the transcriptomic landscape of early cardiac regeneration from model organisms will shed light on evolutionarily conserved pathways in successful cardiac regeneration. Methods -Here we describe a cross-species transcriptomic screen in three model organisms for cardiac regeneration -axolotl, neonatal mice and zebrafish...
January 18, 2018: Circulation
https://www.readbyqxmd.com/read/29343464/cardiorespiratory-fitness-coronary-artery-calcium-and-cardiovascular-disease-events-in-a-cohort-of-generally-healthy-middle-aged-men-results-from-the-cooper-center-longitudinal-study
#7
Nina B Radford, Laura F DeFina, David Leonard, Carolyn E Barlow, Benjamin L Willis, Larry W Gibbons, Susan C Gilchrist, Amit Khera, Benjamin D Levine
Background -A robust literature demonstrates that coronary artery calcification (CAC) and cardiorespiratory fitness (CRF) are independent predictors of cardiovascular disease (CVD) events. Much less is known about the joint associations of CRF and CAC with CVD risk. In the setting of high CAC, high versus low CRF has been associated with decreased CVD events. The goal of this study was to assess the impact of continuous levels of CRF on CVD risk in the setting of increasing CAC burden. Methods -We studied 8,425 men without clinical CVD who underwent preventive medicine examinations that included an objective measurement of CRF and CAC between 1998-2007...
January 17, 2018: Circulation
https://www.readbyqxmd.com/read/29339351/high-target-vs-low-target-blood-pressure-management-during-cardiopulmonary-bypass-to-prevent-cerebral-injury-in-cardiac-surgery-patients-a-randomized-controlled-trial
#8
Anne G Vedel, Frederik Holmgaard, Lars S Rasmussen, Annika Langkilde, Olaf B Paulson, Theis Lange, Carsten Thomsen, Peter Skov Olsen, Hanne Berg Ravn, Jens C Nilsson
Background -Cerebral injury is an important complication following cardiac surgery with the use of cardiopulmonary bypass (CPB). The rate of overt stroke after cardiac surgery is 1-2%, whereas silent strokes, detected by diffusion-weighed magnetic resonance imaging (DWI), are found in up to 50% of patients. It is unclear if a higher versus a lower blood pressure during cardiopulmonary bypass reduces cerebral infarction in these patients. Methods -In a patient- and assessor-blinded randomized trial, we allocated patients to a higher (70-80 mmHg) or lower (40-50 mmHg) target for mean arterial pressure by the titration of norepinephrine during cardiopulmonary bypass...
January 16, 2018: Circulation
https://www.readbyqxmd.com/read/29330215/mir-195-regulates-metabolism-in-failing-myocardium-via-alterations-in-sirt3-expression-and-mitochondrial-protein-acetylation
#9
Xiaokan Zhang, Ruiping Ji, Xianghai Liao, Estibaliz Castillero, Peter J Kennel, Danielle L Brunjes, Marcus Franz, Sven Möbius-Winkler, Konstantinos Drosatos, Isaac George, Emily I Chen, Paolo C Colombo, P Christian Schulze
Background -Heart failure (HF) leads to mitochondrial dysfunction and metabolic abnormalities of the failing myocardium coupled with an energy-depleted state and cardiac remodeling. The mitochondrial deacetylase sirtuin 3 (SIRT3) plays a pivotal role in the maintenance of mitochondrial function through regulating the mitochondrial acetylome. Interestingly, unique cardiac and systemic miRNAs have been shown to play an important role in cardiac remodeling by modulating key signaling elements in the myocardium...
January 12, 2018: Circulation
https://www.readbyqxmd.com/read/29330214/statins-have-a-dose-dependent-effect-on-amputation-and-survival-in-peripheral-artery-disease-patients
#10
Shipra Arya, Anjali Khakharia, Zachary O Binney, Randall R DeMartino, Luke P Brewster, Philip P Goodney, Peter W F Wilson
Background -Statin dose guidelines for Peripheral Artery Disease (PAD) patients are largely based on coronary artery disease and stroke data. The aim of this study is to determine the effect of statin intensity on PAD outcomes of amputation and mortality. Methods -Using an observational cohort study design and a validated algorithm we identified incident PAD patients (2003-2014) in the national Veterans Affairs data. Highest statin intensity exposure [high intensity vs low- moderate intensity vs antiplatelet therapy but no statin use (AP only)] was determined within one year of diagnosis of PAD...
January 12, 2018: Circulation
https://www.readbyqxmd.com/read/29317447/improving-1-year-outcomes-of-infrainguinal-limb-revascularisation-a-population-based-cohort-study-of-104-000-patients-in-england
#11
Katriina Heikkila, David C Mitchell, Ian M Loftus, Amundeep S Johal, Sam Waton, David A Cromwell
Background -The availability and diversity of lower limb revascularisation procedures have increased in England in the past decade. We investigated whether these developments in care have translated to improvements in patient pathways and outcomes. Methods -Individual-patient records from Hospital Episode Statistics (HES) were used to identify 103 934 patients who underwent endovascular (angioplasty) or surgical (endarterectomy, profundaplasty or bypass) lower limb revascularisation for infrainguinal peripheral artery disease (PAD) in England between January 2006 and December 2015...
January 9, 2018: Circulation
https://www.readbyqxmd.com/read/29311053/reversing-the-cardiac-effects-of-sedentary-aging-in-middle-age-a-randomized-controlled-trial-implications-for-heart-failure-prevention
#12
Erin J Howden, Satyam Sarma, Justin S Lawley, Mildred Opondo, William Cornwell, Douglas Stoller, Marcus A Urey, Beverley Adams-Huet, Benjamin D Levine
Background - Poor fitness in middle age is a risk factor for heart failure, particularly heart failure with a preserved ejection fraction. The development of heart failure with a preserved ejection fraction is likely mediated through increased left ventricular (LV) stiffness, a consequence of sedentary aging. In a prospective, parallel group, randomized controlled trial, we examined the effect of 2 years of supervised highintensity exercise training on LV stiffness. Methods - Sixty-one (48% male) healthy, sedentary, middle-aged participants (53±5 years) were randomly assigned to either 2 years of exercise training (n=34) or attention control (control; n=27)...
January 8, 2018: Circulation
https://www.readbyqxmd.com/read/29305529/geographic-variation-in-cardiac-rehabilitation-participation-in-medicare-and-veterans-affairs-populations-an-opportunity-for-improvement
#13
Alexis L Beatty, Michael Truong, David W Schopfer, Hui Shen, Justin M Bachmann, Mary A Whooley
Background -Cardiac rehabilitation is strongly recommended after myocardial infarction (MI), percutaneous coronary intervention (PCI), or coronary artery bypass surgery (CABG), but is historically underused. We sought to evaluate variation in cardiac rehabilitation participation across the United States. Methods -From administrative data from the Veterans Affairs (VA) healthcare system and a 5% Medicare sample, we used ICD-9 codes to identify patients hospitalized for MI, PCI, or CABG from 2007-2011. After excluding patients who died within 30 days of hospitalization, we calculated the percent of patients who participated in one or more outpatient visits for cardiac rehabilitation during the 12 months after hospitalization...
January 5, 2018: Circulation
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#14
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29279412/association-between-prompt-defibrillation-and-epinephrine-treatment-with-long-term-survival-after-in-hospital-cardiac-arrest
#15
Krishna K Patel, John A Spertus, Yevgeniy Khariton, Yuanyuan Tang, Lesley H Curtis, Paul S Chan
Background -Prior studies have reported higher in-hospital survival with prompt defibrillation and epinephrine treatment in patients suffering in-hospital cardiac arrest (IHCA). Whether this survival benefit persists after discharge is unknown. Methods -We linked data from a national IHCA registry with Medicare files and identified 36,961 patients aged ≥65 years with an IHCA at 517 hospitals between 2000 and 2011. Patients with IHCA due to pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) were stratified by prompt (≤2 min) vs...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29273581/mortality-differences-associated-with-treatment-responses-in-cantos-and-fourier-insights-and-implications
#16
Paul M Ridker
Similarities and differences in two contemporary post-randomization on-treatment analyses from the FOURIER and CANTOS trials may provide insight into what factors drive reductions in cardiovascular mortality and all-cause mortality among atherosclerosis patients already treated with high intensity statins. In the first paper, the FOURIER investigators elegantly demonstrate that lower is better for low-density lipoprotein cholesterol (LDLC) after adjunctive therapy with the PCSK9 inhibitor evolocumab1 For the FOURIER primary endpoint (a composite of myocardial infarction, stroke, coronary revascularization, unstable angina, or cardiovascular death), there was a highly significant monotonic relationship between sequentially lower achieved LDLC concentrations and lower cardiovascular risk, extending even to those with on-treatment LDLC below 20 mg/dL...
December 22, 2017: Circulation
https://www.readbyqxmd.com/read/29269390/prognostic-implications-of-magnetic-resonance-derived-quantification-in-asymptomatic-patients-with-organic-mitral-regurgitation-comparison-with-doppler-echocardiography-derived-integrative-approach
#17
Martin Penicka, Jan Vecera, Daniela C Mirica, Martin Kotrc, Radka Kockova, Guy Van Camp
Background -Magnetic resonance imaging (MRI) is an accurate method for the quantitative assessment of organic mitral regurgitation (OMR). The aim of the present study was to compare the discriminative power of MRI quantification and the recommended Doppler-echocardiography (ECHO)-derived integrative approach to identify asymptomatic patients with OMR and adverse outcome. Methods -The study population consisted of 258 asymptomatic patients (63±14 years, 60% males) with preserved left ventricular (LV) ejection fraction (>60%) and chronic moderate and severe OMR (flail 25%, prolapse 75%) defined using the ECHO-derived integrative approach...
December 21, 2017: Circulation
https://www.readbyqxmd.com/read/29269389/exposure-to-low-dose-ionizing-radiation-from-cardiac-procedures-and-malignancy-risk-in-adults-with-congenital-heart-disease
#18
Sarah Cohen, Aihua Liu, Michelle Gurvitz, Liming Guo, Judith Therrien, Claudie Laprise, Jay S Kaufman, Michal Abrahamowicz, Ariane J Marelli
Background -Adults with congenital heart disease (ACHD) are exposed to increasing amounts of low-dose ionizing radiation (LDIR) from cardiac procedures. Cancer prevalence in this population is higher compared to the general population. This study estimates the association between LDIR exposure from cardiac procedures and incident cancer in ACHD patients. Methods -The study population derived from the Quebec CHD Database. We measured cumulative numbers of LDIR-related cardiac procedures for each patient until one year before time of cancer diagnosis or administrative censoring...
December 21, 2017: Circulation
https://www.readbyqxmd.com/read/29269388/risk-factors-of-sudden-cardiac-death-in-the-young-a-multiple-year-community-wide-assessment
#19
Reshmy Jayaraman, Kyndaron Reinier, Sandeep Nair, Aapo L Aro, Audrey Uy-Evanado, Carmen Rusinaru, Eric C Stecker, Karen Gunson, Jonathan Jui, Sumeet S Chugh
Background -Prevention of sudden cardiac arrest (SCA) in the young remains a largely unsolved public health problem and sports activity is an established trigger. While the presence of standard cardiovascular risk factors in the young can link to future morbidity and mortality in adulthood, the potential contribution of these risk factors to SCA in the young has not been evaluated. Methods -We prospectively ascertained subjects who suffered SCA between the ages of 5-34 years in the Portland, Oregon, USA metropolitan area (2002-2015, catchment population approximately 1 million)...
December 21, 2017: Circulation
https://www.readbyqxmd.com/read/29263150/benefit-of-adding-ezetimibe-to-statin-therapy-on-cardiovascular-outcomes-and-safety-in-patients-with-vs-without-diabetes-results-from-improve-it
#20
Robert P Giugliano, Christopher P Cannon, Michael A Blazing, Jose C Nicolau, Ramon Corbalan, Jindrich Spinar, Jeong-Gun Park, Jennifer A White, Erin Bohula, Eugene Braunwald
Background -Ezetimibe, when added to simvastatin, reduces cardiovascular events following acute coronary syndrome (ACS); we explored outcomes stratified by diabetes mellitus (DM). Methods -In IMPROVE-IT, 18,144 patients post ACS with LDL-C 50-125 mg/dL were randomized to ezetimibe/simvastatin-40mg (E/S) or placebo/simvastatin-40mg (P/S). The primary composite endpoint was cardiovascular death, major coronary events, and stroke. DM was a prespecified subgroup. Results -The 4933 (27%) patients with DM were more often older, female, with prior MI and revascularization, and presented more frequently with non-ST segment elevation ACS compared to non-DM (each p<0...
December 20, 2017: Circulation
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