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Circulation

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https://www.readbyqxmd.com/read/28939617/the-j-curve-in-patients-randomly-assigned-to-different-systolic-blood-pressure-targets-an-experimental-approach-to-an-observational-paradigm
#1
Deborah N Kalkman, Tom F Brouwer, Jim T Vehmeijer, Wouter R Berger, Reinoud E Knops, Robbert J de Winter, Ron J Peters, Bert-Jan H van den Born
Background -Low systolic blood pressure (SBP) values are associated with an increased risk of cardiovascular events, giving rise to the so called J-curve phenomenon. We assessed the association between on-treatment SBP levels, cardiovascular events and all-cause mortality in patients randomized to different SBP targets. Methods -Data from two large randomized trials that randomly allocated hypertensive patients at high-risk for cardiovascular disease to intensive (SBP<120 mmHg) or conventional treatment (SBP<140 mmHg) were pooled and harmonized for outcomes and follow-up duration...
September 22, 2017: Circulation
https://www.readbyqxmd.com/read/28935667/upregulation-of-herv-k-is-linked-to-immunity-and-inflammation-in-pulmonary-arterial-hypertension
#2
Toshie Saito, Kazuya Miyagawa, Shih-Yu Chen, Rasa Tamosiuniene, Lingli Wang, Orr Sharp, Erik Samayoa, Daisuke Harada, Jan-Renier A J Moonen, Aiqin Cao, Pin-I Chen, Jan K Hennigs, Mingxia Gu, Caiyun G Li, Ryan D Leib, Dan Li, Christopher M Adams, Patricia A Del Rosario, Matthew A Bill, Francois Haddad, Jose G Montoya, William Robinson, Wendy J Fantl, Garry P Nolan, Roham T Zamanian, Mark R Nicolls, Charles Y Chiu, Maria E Ariza, Marlene Rabinovitch
Background -Immune dysregulation has been linked to occlusive vascular remodeling in pulmonary arterial hypertension (PAH) that is hereditary, idiopathic or associated with other conditions. Circulating autoantibodies, lung perivascular lymphoid tissue and elevated cytokines have been related to PAH pathogenesis but without clear understanding of how these abnormalities are initiated, perpetuated and connected in the progression of disease. We therefore set out to identify specific target antigens in PAH lung immune complexes as a starting point toward resolving these issues to better inform future application of immunomodulatory therapies...
September 21, 2017: Circulation
https://www.readbyqxmd.com/read/28931551/endoplasmic-reticulum-membrane-protein-complex-subunit-10-emc10-is-a-bone-marrow-derived-angiogenic-growth-factor-promoting-tissue-repair-after-myocardial-infarction
#3
Marc R Reboll, Mortimer Korf-Klingebiel, Stefanie Klede, Felix Polten, Eva Brinkmann, Ines Reimann, Hans-Joachim Schönfeld, Maria Bobadilla, Jan Faix, George Kensah, Ina Gruh, Michael Klintschar, Matthias Gaestel, Hans W Niessen, Andreas Pich, Johann Bauersachs, Joseph A Gogos, Yong Wang, Kai C Wollert
Background -Clinical trials of bone marrow cell (BMC)-based therapies after acute myocardial infarction (MI) have produced mostly neutral results. Treatment with specific BMC-derived secreted proteins may provide an alternative biologic approach to improving tissue repair and heart function after MI. We recently performed a bioinformatic secretome analysis in BMCs from patients with acute MI and discovered a poorly characterized secreted protein, endoplasmic reticulum membrane protein complex subunit 10 (EMC10), showing activity in an angiogenic screen...
September 20, 2017: Circulation
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#4
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
September 18, 2017: Circulation
https://www.readbyqxmd.com/read/28916641/inflammation-and-atherosclerosis-the-end-of-a-controversy
#5
Göran K Hansson
Does inflammation matter in coronary artery disease? Is it a driving force in atherosclerosis, or merely an epiphenomenon? And is there space for novel therapies besides those targeting cholesterol? The CANTOS trial, which was presented at the European Society of Cardiology meeting in Barcelona a few weeks ago provides answers to these important questions. Indeed, the results of this trial open up a new avenue for cardiovascular prevention.
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#6
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28912371/preprints-and-cardiovascular-science-prescient-or-premature
#7
Brahmajee K Nallamothu, Joseph A Hill
Medical journals currently find themselves in the throes of 2 powerful trends: (1) a growing concern for the irreproducibility of scientific reports, and (2) a rising imperative to accelerate dissemination of new knowledge in the digital era. Without question, the individual merit of tackling each issue is readily apparent. Irreproducibility of scientific reports is surprisingly common and contributes to an overall loss of confidence in research by the public and other stakeholders. And who could argue with efforts to leverage new online technologies to distribute information as rapidly and widely as possible?...
September 14, 2017: Circulation
https://www.readbyqxmd.com/read/28904070/antiarrhythmic-drugs-for-non-shockable-turned-shockable-out-of-hospital-cardiac-arrest-the-amiodarone-lidocaine-or-placebo-study-alps
#8
Peter J Kudenchuk, Brian G Leroux, Mohamud Daya, Thomas Rea, Christian Vaillancourt, Laurie J Morrison, Clifton W Callaway, James Christenson, Joseph P Ornato, James V Dunford, Lynn Wittwer, Myron L Weisfeldt, Tom P Aufderheide, Gary M Vilke, Ahamed H Idris, Ian G Stiell, M Riccardo Colella, Tami Kayea, Debra A Egan, Patrice Desvigne-Nickens, Pamela Gray, Randal Gray, Ron Straight, Paul Dorian
Background -Out-of-hospital cardiac arrest (OHCA) commonly presents with non-shockable rhythms (asystole and pulseless electrical activity (PEA)). Whether antiarrhythmic drugs are safe and effective when these evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/VT)) during resuscitation is not known. Methods -Adults with non-traumatic OHCA, vascular access and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine or placebo by paramedics...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28904069/disturbed-placental-imprinting-in-preeclampsia-leads-to-altered-expression-of-dlx5-a-human-specific-early-trophoblast-marker
#9
Julianna Zadora, Manvendra Singh, Florian Herse, Lukasz Przybyl, Nadine Haase, Michaela Golic, Hong Wa Yung, Berthold Huppertz, Judith E Cartwright, Guy S Whitley, Guro M Johnsen, Giovanni Levi, Annette Isbruch, Herbert Schulz, Friedrich C Luft, Dominik N Müller, Anne C Staff, Laurence D Hurst, Ralf Dechend, Zsuzsanna Izsvák
Background -Preeclampsia (PE) is a complex and common human-specific pregnancy syndrome associated with placental pathology. The human-specificity provides both intellectual and methodological challenges, lacking a robust model system. Given the role of imprinted genes in human placentation and the vulnerability of imprinted genes to loss of imprinting changes, there has been extensive speculation, but no robust evidence, that imprinted genes are involved in PE. Our study aims at investigating whether disturbed imprinting contributes to PE...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28904068/empagliflozin-and-clinical-outcomes-in-patients-with-type-2-diabetes-established-cardiovascular-disease-and-chronic-kidney-disease
#10
Christoph Wanner, John M Lachin, Silvio E Inzucchi, David Fitchett, Michaela Mattheus, Jyothis T George, Hans-Juergen Woerle, Uli C Broedl, Maximilian von Eynatten, Bernard Zinman
Background -Empagliflozin, a sodium glucose cotransporter 2 inhibitor, reduced cardiovascular morbidity and mortality in patients with type 2 diabetes and established cardiovascular disease in the EMPA-REG OUTCOME(®) trial. Urinary glucose excretion with empagliflozin decreases with declining renal function, resulting in less potency for glucose lowering in patients with kidney disease. We investigated the effects of empagliflozin on clinical outcomes in patients with type 2 diabetes, established cardiovascular disease and chronic kidney disease...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28893843/timing-of-angiography-and-outcomes-in-high-risk-patients-with-non-st-segment-elevation-myocardial-infarction-managed-invasively-insights-from-the-tao-trial
#11
Pierre Deharo, Gregory Ducrocq, Christoph Bode, Marc Cohen, Thomas Cuisset, Shamir Mehta, Charles V Pollack, Stephen D Wiviott, Yedid Elbez, Marc Sabatine, P Gabriel Steg
Background -In patients with non ST-elevation myocardial infarction (NSTEMI) and Global Registry of Acute Coronary Events (GRACE) score >140, coronary angiography (CAG) is recommended by European and American guidelines within 24h. We sought to study the association of a "very early" (i.e. ≤12h), early (12-24h) and delayed (>24h) CAG in NSTEMI with GRACE score >140 with ischemic outcomes. Methods -The Treatment of Acute coronary syndrome with Otamixaban (TAO) trial randomized patients with NSTEMI and CAG scheduled within 72h to heparin plus eptifibatide versus otamixaban...
September 11, 2017: Circulation
https://www.readbyqxmd.com/read/28882886/potential-cardiovascular-and-total-mortality-benefits-of-air-pollution-control-in-urban-china
#12
Chen Huang, Andrew E Moran, Pamela G Coxson, Xueli Yang, Fangchao Liu, Jie Cao, Kai Chen, Miao Wang, Jiang He, Lee Goldman, Dong Zhao, Patrick L Kinney, Dongfeng Gu
Background -Outdoor air pollution ranks fourth among preventable causes of China's burden of disease. We hypothesized that the magnitude of health gains from air quality improvement in urban China could compare with achieving recommended blood pressure or smoking control goals. Methods -The Cardiovascular Disease Policy Model-China projected coronary heart disease, stroke, and all-cause deaths in urban Chinese adults aged 35-84 years from 2017 to 2030 if recent air quality (particulate matter with aerodynamic diameter ≤ 2...
September 7, 2017: Circulation
https://www.readbyqxmd.com/read/28882885/modeling-major-adverse-outcomes-of-pediatric-and-adult-patients-with-congenital-heart-disease-undergoing-cardiac-catheterization-observations-from-the-ncdr-impact-registry
#13
Natalie Jayaram, John A Spertus, Kevin F Kennedy, Robert Vincent, Gerard R Martin, Jeptha P Curtis, David G Nykanen, Phillip M Moore, Lisa Bergersen
Background -Risk-standardization for adverse events following congenital cardiac catheterization is needed to equitably compare patient outcomes among different hospitals as a foundation for quality improvement. The goal of this project was to develop a risk-standardization methodology to adjust for patient characteristics when comparing major adverse outcomes in the NCDR® IMPACT(TM) (Improving Pediatric and Adult Congenital Treatment) Registry. Methods -39,725 consecutive patients within IMPACT undergoing cardiac catheterization between January 2011 and March 2014 were identified...
September 7, 2017: Circulation
https://www.readbyqxmd.com/read/28877914/age-and-outcomes-of-primary-prevention-implantable-cardioverter-defibrillators-in-patients-with-non-ischemic-systolic-heart-failure
#14
Marie Bayer Elming, Jens C Nielsen, Jens Haarbo, Lars Videbæk, Eva Korup, James Signorovitch, Line Lisbeth Olesen, Per Hildebrandt, Flemming H Steffensen, Niels E Bruun, Hans Eiskjær, Axel Brandes, Anna M Thøgersen, Finn Gustafsson, Kenneth Egstrup, Regitze Videbæk, Christian Hassager, Jesper Hastrup Svendsen, Dan E Høfsten, Christian Torp-Pedersen, Steen Pehrson, Lars Køber, Jens Jakob Thune
Background -The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators (ICD) in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH) did not demonstrate an overall effect on all-cause mortality with ICD implantation. However, the pre-specified subgroup analysis suggested a possible age-dependent association between the ICD and mortality with survival benefit seen only in the youngest patients. The nature of this relationship between age and outcome of a primary prevention ICD in patients with non-ischemic systolic heart failure warrants further investigation...
September 6, 2017: Circulation
https://www.readbyqxmd.com/read/28877913/ldl-cholesterol-lowering-for-the-primary-prevention-of-cardiovascular-disease-among-men-with-primary-elevations-of-ldl-cholesterol-levels-of-190-mg-dl-or-above-analyses-from-the-woscops-5-year-randomised-trial-and-20-year-observational-follow-up
#15
Antonio J Vallejo-Vaz, Michele Robertson, Alberico L Catapano, Gerald F Watts, John J Kastelein, Chris J Packard, Ian Ford, Kausik K Ray
Background -Patients with primary elevations of LDL-C ≥190 mg/dL are at a higher risk of atherosclerotic cardiovascular disease as a result of long-term exposure to markedly elevated LDL-C levels. Therefore, initiation of statin therapy is recommended for these individuals. However, there is a lack of randomised trial evidence supporting these recommendations in primary prevention. In the present analysis we provide hitherto unpublished data on the cardiovascular effects of LDL-C lowering among a primary prevention population with LDL-C ≥190 mg/dL...
September 6, 2017: Circulation
https://www.readbyqxmd.com/read/28864444/hypoplastic-left-heart-syndrome-with-intact-or-restrictive-atrial-septum-a-report-from-the-international-fetal-cardiac-intervention-registry
#16
David W Jantzen, Anita J Moon-Grady, Shaine A Morris, Aimee K Armstrong, Christoph Berg, Joanna H Dangel, Carlen G Fifer, Michele Frommelt, Ulrich Gembruch, Ulrike Herberg, Edgar T Jaeggi, Eftichia V Kontopoulos, Audrey C Marshall, Owen Miller, Renate Oberhoffer, Dick Oepkes, Carlos A Pedra, Simone R Pedra, Fabio Peralta, Ruben A Quintero, Greg Ryan, Sarah K Gelehrter
Infants with hypoplastic left heart syndrome and an intact or highly restrictive atrial septum (HLHS-IAS) represent a high risk subset. Fetal cardiac intervention (FCI) for fetuses with HLHS-IAS has been reported in single-institution series as a therapy that may improve outcomes. This study utilizes the International Fetal Cardiac Intervention Registry (IFCIR) to examine fetal and maternal characteristics and pregnancy and neonatal outcome data for FCI in this population.
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-ncdr%C3%A2-sts-acc-tvt-registry
#17
Matthew C Hyman, Sreekanth Vemulapalli, Wilson Y Szeto, Amanda Stebbins, Prakash A Patel, Roland A Matsouaka, Howard C Herrmann, Saif Anwaruddin, Taisei Kobayashi, Nimesh D Desai, Prashanth Vallabhajosyula, Fenton H McCarthy, Robert Li, Joseph E Bavaria, Jay Giri
Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014 and June 30, 2015. Raw and inverse probability of treatment weighted (IPTW) analyses were performed to compare general anesthesia patients with conscious sedation patients on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, ICU and hospital length-of-stay, and rates of discharge to home...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28864442/integrated-non-invasive-physiological-assessment-of-coronary-circulatory-function-and-impact-on-cardiovascular-mortality-in-patients-with-stable-coronary-artery-disease
#18
Ankur Gupta, Viviany R Taqueti, Tim P van de Hoef, Navkaranbir S Bajaj, Paco E Bravo, Venkatesh L Murthy, Michael T Osborne, Sara B Seidelmann, Tomas S Vita, Courtney F Bibbo, Meagan Harrington, Jon Hainer, Ornella Rimoldi, Sharmila Dorbala, Deepak L Bhatt, Ron Blankstein, Paolo G Camici, Marcelo F Di Carli
Background -It is suggested that the integration of maximal myocardial blood flow (MBF) and coronary flow reserve (CFR), termed coronary flow capacity, allows comprehensive evaluation of patients with known or suspected stable coronary artery disease. As management decisions are predicated on clinical risk, we sought to determine the independent and integrated value of maximal MBF and CFR for predicting cardiovascular death. Methods -MBF and CFR were quantified in 4,029 consecutive patients (median age 66 years, 50...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28860123/circular-non-coding-rna-hipk3-mediates-retinal-vascular-dysfunction-in-diabetes-mellitus
#19
Kun Shan, Chang Liu, Bai-Hui Liu, Xue Chen, Rui Dong, Xin Liu, Yang-Yang Zhang, Ban Liu, Shu-Jie Zhang, Jia-Jian Wang, Sheng-Hai Zhang, Ji-Hong Wu, Chen Zhao, Biao Yan
Background -The vascular complications of diabetes mellitus are the major causes of morbidity and mortality among people with diabetes. Circular RNAs (circRNAs) are a class of endogenous non-coding RNAs that regulate gene expression in eukaryotes. In this study, we investigated the role of circRNA in retinal vascular dysfunction induced by diabetes. Methods -Quantitative polymerase chain reactions, Sanger sequencing, and Northern blots were conducted to detect circHIPK3 expression pattern upon diabetes mellitus-related stresses...
August 31, 2017: Circulation
https://www.readbyqxmd.com/read/28860122/exercise-induced-changes-in-glucose-metabolism-promote-physiologic-cardiac-growth
#20
Andrew A Gibb, Paul N Epstein, Shizuka Uchida, Yuting Zheng, Lindsey A McNally, Detlef Obal, Kartik Katragadda, Patrick J Trainor, Daniel J Conklin, Kenneth R Brittian, Michael T Tseng, Jianxun Wang, Steven P Jones, Aruni Bhatnagar, Bradford G Hill
Background -Exercise promotes metabolic remodeling in the heart, which is associated with physiologic cardiac growth; however, it is not known whether or how physical activity-induced changes in cardiac metabolism cause myocardial remodeling. In this study, we tested whether exercise-mediated changes in cardiomyocyte glucose metabolism are important for physiologic cardiac growth. Methods -We used radiometric, immunologic, metabolomic, and biochemical assays to measure changes in myocardial glucose metabolism in mice subjected to acute and chronic treadmill exercise...
August 31, 2017: Circulation
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