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Clinical Medicine Insights. Cardiology

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https://www.readbyqxmd.com/read/27867305/pulmonary-hypertension-in-heart-failure-patients-presenting-at-oauthc-ile-ife-nigeria
#1
Valentine N Amadi, Olufemi E Ajayi, Anthony O Akintomide, Olugbenga O Abiodun, Olaniyi J Bamikole, Michael O Balogun
BACKGROUND: Pulmonary hypertension (PH) is common in heart failure patients. Literature on PH in heart failure is sparse in Nigeria. This study was carried out to determine the prevalence of PH in heart failure patients and ascertain the relationship between left ventricular systolic and diastolic function and the degree of PH. METHODS: A total of 125 heart failure patients had echocardiography done. PH was diagnosed using tricuspid regurgitation jet and pulmonary ejection jet profile...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27840581/light-based-approaches-to-cardiac-arrhythmia-research-from-basic-science-to-translational-applications
#2
REVIEW
Thomas V Karathanos, Patrick M Boyle, Natalia A Trayanova
Light has long been used to image the heart, but now it can be used to modulate its electrophysiological function. Imaging modalities and techniques have long constituted an indispensable part of arrhythmia research and treatment. Recently, advances in the fields of optogenetics and photodynamic therapy have provided scientists with more effective approaches for probing, studying and potentially devising new treatments for cardiac arrhythmias. This article is a review of research toward the application of these techniques...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27840580/rationale-and-design-of-randomized-clinical-trial-for-the-assessment-of-macitentan-efficiency-as-coadjuvant-treatment-to-open-and-endovascular-revascularization-in-critical-limb-ischemia
#3
Ignacio Michel, Joaquin De Haro, Silvia Bleda, Ilsem V Laime, Jhenifer Uyaguari, Francisco Acin
INTRODUCTION: Critical limb ischemia (CLI) is defined by ischemic rest pain, tissue loss, or both, secondary to arterial insufficiency, and its prevalence is increasing mainly as a result of the worldwide high prevalence of diabetes. Currently, there are no available conclusive data on the efficacy of any coadjuvant therapy after revascularization procedure benefiting amputation and patency rates. Macitentan is an orally active dual endothelin (ET) receptor antagonist that may contribute to reduce the amputation rate and improve revascularization patency in CLI...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27812293/atrial-electrophysiological-remodeling-and-fibrillation-in-heart-failure
#4
REVIEW
Sandeep V Pandit, Antony J Workman
Heart failure (HF) causes complex, chronic changes in atrial structure and function, which can cause substantial electrophysiological remodeling and predispose the individual to atrial fibrillation (AF). Pharmacological treatments for preventing AF in patients with HF are limited. Improved understanding of the atrial electrical and ionic/molecular mechanisms that promote AF in these patients could lead to the identification of novel therapeutic targets. Animal models of HF have identified numerous changes in atrial ion currents, intracellular calcium handling, action potential waveform and conduction, as well as expression and signaling of associated proteins...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27790050/arrhythmogenic-right-ventricular-dysplasia-in-neuromuscular-disorders
#5
REVIEW
Josef Finsterer, Claudia Stöllberger
OBJECTIVES: Arrhythmogenic right ventricular dysplasia (ARVD) is a rare, genetic disorder predominantly affecting the right ventricle. There is increasing evidence that in some cases, ARVD is due to mutations in genes, which have also been implicated in primary myopathies. This review gives an overview about myopathy-associated ARVD and how these patients can be managed. METHODS: A literature review was done using appropriate search terms. RESULTS: The myopathy, which is most frequently associated with ARVD, is the myofibrillar myopathy due to desmin mutations...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27773994/a-review-of-the-external-validity-of-clinical-trials-with-beta-blockers-in-heart-failure
#6
Pupalan Iyngkaran, Samia R Toukhsati, Merlin C Thomas, Michael V Jelinek, David L Hare, John D Horowitz
BACKGROUND: Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27656092/echocardiographic-assessment-of-cardiac-changes-during-normal-pregnancy-among-nigerians
#7
V O Adeyeye, M O Balogun, R A Adebayo, O N Makinde, P O Akinwusi, E A Ajayi, S A Ogunyemi, A O Akintomide, E O Ajayi, A G Adeyeye, T O Ojo, O O Abiodun
BACKGROUND: Pregnancy is a physiological process associated with an increased hemodynamic load and cardiac structural remodeling. Limited echocardiographic information exists on cardiac chambers, left ventricular (LV) systolic and diastolic functions, and LV mass during trimesters of normal pregnancy among African women. MATERIALS AND METHODS: Echocardiography was done at the beginning of the second trimester, beginning of the third trimester, and middle of the third trimester for 100 normal pregnant women and at one visit for age-matched 100 nonpregnant women...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27597810/prasugrel-results-in-higher-decrease-in-high-sensitivity-c-reactive-protein-level-in-patients-undergoing-percutaneous-coronary-intervention-comparing-to-clopidogrel
#8
Shokoufeh Hajsadeghi, Mandana Chitsazan, Mitra Chitsazan, Negar Salehi, Ahmad Amin, Arash Amin Bidokhti, Nima Babaali, Armin Bordbar, Maral Hejrati, Samar Moghadami
OBJECTIVES: A growing body of clinical and laboratory evidence indicates that inflammation plays a crucial role in atherosclerosis. In the present study, we compared the effects of clopidogrel and prasugrel on high-sensitivity C-reactive protein (hs-CRP) in patients undergoing percutaneous coronary intervention (PCI). METHODS: The present randomized, double-blind clinical trial included 120 patients who underwent PCI. Eligible patients were randomly assigned 2:1 to one of the two groups: 80 patients in the first group received clopidogrel (Plavix(®); loading dose and maintenance dose of 300 and 75 mg daily, respectively) and 40 patients in the second group received prasugrel (Effient(®); loading dose and maintenance dose of 60 and 10 mg, respectively) for 12 weeks...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27594790/acute-effects-of-vagotomy-on-baroreflex-equilibrium-diagram-in-rats-with-chronic-heart-failure
#9
Toru Kawada, Meihua Li, Can Zheng, Masaru Sugimachi
The arterial baroreflex system can be divided into the neural arc, from pressure input to efferent sympathetic nerve activity (SNA), and the peripheral arc, from SNA to arterial pressure (AP). Plotting the neural and peripheral arcs on a pressure-SNA plane yields a baroreflex equilibrium diagram. We examined the effects of vagotomy on the open-loop static characteristics of the carotid sinus baroreflex in normal control rats (NC, n = 10) and rats with heart failure after myocardial infarction (MI, n = 10). In the NC group, vagotomy shifted the neural arc toward higher SNA and decreased the slope of the peripheral arc...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27547041/implementation-of-a-screening-program-for-patients-at-risk-for-posttraumatic-stress-disorder
#10
Carmen R Roberts, Joanie E Wofford, Haley M Hoy, Mitchell N Faddis
INTRODUCTION: Implantable cardioverter defibrillator (ICD) recipients who suffer from posttraumatic stress disorder (PTSD) are known to be associated with significant cardiac-specific mortality. Clinical observations suggest that PTSD is frequently undetected in ICD recipients followed up at electrophysiology (EP) outpatient clinics. Early recognition of PTSD is important to reduce the risk of serious manifestations on patient outcomes. METHODS: All ICD recipients aged 19 years or older at the Washington University School of Medicine (WASHU) EP clinic, a large urban EP clinic, were invited to participate in the project...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27486348/computational-representations-of-myocardial-infarct-scars-and-implications-for-arrhythmogenesis
#11
REVIEW
Adam J Connolly, Martin J Bishop
Image-based computational modeling is becoming an increasingly used clinical tool to provide insight into the mechanisms of reentrant arrhythmias. In the context of ischemic heart disease, faithful representation of the electrophysiological properties of the infarct region within models is essential, due to the scars known for arrhythmic properties. Here, we review the different computational representations of the infarcted region, summarizing the experimental measurements upon which they are based. We then focus on the two most common representations of the scar core (complete insulator or electrically passive tissue) and perform simulations of electrical propagation around idealized infarct geometries...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27478391/role-of-cytosolic-calcium-diffusion-in-murine-cardiac-purkinje-cells
#12
REVIEW
Bijay Limbu, Kushal Shah, Seth H Weinberg, Makarand Deo
Cardiac Purkinje cells (PCs) are morphologically and electrophysiologically different from ventricular myocytes and, importantly, exhibit distinct calcium (Ca(2+)) homeostasis. Recent studies suggest that PCs are more susceptible to action potential (AP) abnormalities than ventricular myocytes; however, the exact mechanisms are poorly understood. In this study, we utilized a detailed biophysical mathematical model of a murine PC to systematically examine the role of cytosolic Ca(2+) diffusion in shaping the AP in PCs...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27478390/switching-from-epa-dha-omega-3-acid-ethyl-esters-to-high-purity-epa-icosapent-ethyl-in-a-statin-treated-patient-with-persistent-dyslipidemia-and-high-cardiovascular-risk-a-case-study
#13
James R Crandell
Cardiovascular (CV) risk may remain despite statin treatment, and there is a need to address this risk with add-on therapy. The lipid effects of two different prescription omega-3 fatty acid therapies are described in a 55-year-old statin- and niacin-treated female with severe dyslipidemia and high CV risk. The patient was initially treated with omega-3-acid ethyl esters (eicosapentaenoic acid [EPA] and docosahexaenoic acid) 4 g/day. Due to persistently elevated low-density lipoprotein cholesterol (LDL-C), she was switched to icosapent ethyl (high-purity EPA ethyl ester) 4 g/day...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27429563/prevalence-clinical-characteristics-and-predictors-of-patients-with-thromboembolic-events-in-takotsubo-cardiomyopathy
#14
Ibrahim El-Battrawy, Michael Behnes, Dennis Hillenbrand, Darius Haghi, Ursula Hoffmann, Theano Papavassiliu, Siegfried Lang, Christian Fastner, Tobias Becher, Stefan Baumann, Felix Heggemann, Jürgen Kuschyk, Martin Borggrefe, Ibrahim Akin
BACKGROUND: Several acute complications related to takotsubo cardiomyopathy (TTC) have been documented recently. However, the incidence and clinical significance of acute thromboembolic events in TTC is not well established. METHODS: A detailed investigation of the clinical characteristics and in-hospital complications of 114 consecutive patients diagnosed with TTC between January 2003 and September 2015 was carried out. This study was initiated to reveal the predictors, clinical significance, and short-term and long-term outcomes of patients with TTC associated with acute thromboembolic events on index presentation...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27398036/hypertension-among-outpatients-at-a-general-hospital-in-south-angola-prevalence-awareness-treatment-and-control
#15
Feliciano C Paquissi, Arminda B P Cuvinje, Almeida B Cuvinje, Arlindo M Paquissi
OBJECTIVE: This study aimed to assess the prevalence, awareness, treatment, and control of hypertension in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. METHODS: A total of 265 subjects aged 18 years and older were included. Evaluation included complete interview and blood pressure measurement using a validated automatic device. RESULTS: The prevalence rates of hypertension and prehypertension were 38...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27398035/outcomes-of-des-in-diabetic-and-nondiabetic-patients-with-complex-coronary-artery-disease-after-risk-stratification-by-the-syntax-score
#16
Mohamed Loutfi, Mohamed A Sadaka, Mohamed Sobhy
UNLABELLED: Diabetes mellitus (DM) increases the risk of adverse outcomes after coronary revascularization. Controversy persists regarding the optimal revascularization strategy for diabetic patients with multivessel coronary artery disease (MVD). AIM: The aim of this study was to assess the outcomes of drug-eluting stent (DES) insertion in DM and non-DM patients with complex coronary artery disease (CAD) after risk stratification by the percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27398034/renal-artery-stenosis-in-a-young-female-without-fibromuscular-dysplasia-with-literature-review
#17
Paloma Peralta, Matthew Cholankeril, Daniel Goldberg, Jayanth Koneru, Fayez Shamoon
Renal artery stenosis (RAS) is rare in young patients without fibromuscular dysplasia (FMD). RAS is primarily classified as having two major etiologies, namely, atherosclerosis and FMD, with 90% and 10%, respectively. We report a case of a female in her mid 20s who developed hypertension due to RAS with no evidence of FMD or underlying renal dysfunction and underwent successful angioplasty and stenting.
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27398033/volume-measurements-in-aortic-root-assessment-using-two-dimensional-echocardiography
#18
Adebayo T Oyedeji, Bolaji E Egbewale, Adeseye A Akintunde, Ebenezer A Ajayi, Olukolade O Owojori, Michael O Balogun
BACKGROUND: Aortic dilatation is associated with the presence of aortic diseases. Current guidelines for assessing the aortic root (AoR) depend on linear measurements acquired by two-dimensional (2D) echocardiography. We considered that real-time three-dimensional echocardiography, which correlates better with AoR volume obtained by computed tomography, is widely unavailable, and therefore, there is a need to determine the AoR volume using 2D echocardiography. METHODS: Fifty-one consecutive apparently healthy volunteers were recruited and subsequently divided into three age groups...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27385917/impaired-sarcoplasmic-reticulum-calcium-uptake-and-release-promote-electromechanically-and-spatially-discordant-alternans-a-computational-study
#19
Seth H Weinberg
Cardiac electrical dynamics are governed by cellular-level properties, such as action potential duration (APD) restitution and intracellular calcium (Ca) handling, and tissue-level properties, including conduction velocity restitution and cell-cell coupling. Irregular dynamics at the cellular level can lead to instabilities in cardiac tissue, including alternans, a beat-to-beat alternation in the action potential and/or the intracellular Ca transient. In this study, we incorporate a detailed single cell coupled map model of Ca cycling and bidirectional APD-Ca coupling into a spatially extended tissue model to investigate the influence of sarcoplasmic reticulum (SR) Ca uptake and release properties on alternans and conduction block...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27385916/subclinical-lv-dysfunction-detection-using-speckle-tracking-echocardiography-in-hypertensive-patients-with-preserved-lv-ejection-fraction
#20
Amal Mohamed Ayoub, Viola William Keddeas, Yasmin Abdelrazek Ali, Reham Atef El Okl
BACKGROUND: Early detection of subclinical left ventricular (LV) systolic dysfunction in hypertensive patients is important for the prevention of progression of hypertensive heart disease. METHODS: We studied 60 hypertensive patients (age ranged from 21 to 49 years, the duration of hypertension ranged from 1 to 18 years) and 30 healthy controls, all had preserved left ventricular ejection fraction (LVEF), detected by two-dimensional speckle tracking echocardiography (2D-STE)...
2016: Clinical Medicine Insights. Cardiology
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