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left ventrícular failure

Cristina Aurigemma, Francesco Burzotta, Giulio Russo, Leonardo Previ, Carlo Trani
The Completeness of Revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy...
March 15, 2018: Minerva Cardioangiologica
Napatt Kanjanahattakij, Benjamin Horn, Basma Abdulhadi, Nicha Wongjarupong, Kenechukwu Mezue, Pattara Rattanawong
Cerebrovascular accident (CVA) is one of the major complications and a leading cause of death in patients with a left ventricular assist device (LVAD). Multiple studies of have shown that patients with blood stream infection (BSI) are more likely to develop CVA compared to patients without BSI. However, there is no meta-analysis to confirm this association. Studies were systematically acquired from MEDLINE and EMBASE electronic databases. Included studies assessed patients with heart failure requiring LVAD and reported the number of patients who had BSI post LVAD, incidence of ischemic CVA, hemorrhagic CVA, or any CVA...
March 16, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Sven Persoon, Michael Paulus, Stephan Hirt, Carsten Jungbauer, Alexander Dietl, Andreas Luchner, Christof Schmid, Lars S Maier, Christoph Birner
Implantation of left ventricular assist devices (LVADs) as bridge to transplant in end-stage heart failure allows for analyzing reverse remodeling processes of the supported heart. Whether this therapy influences the cGMP-PKG signaling pathway, which is currently under thorough investigation for developing new heart failure therapeutics, is unknown. In fourteen end-stage heart failure patients (8 with dilated cardiomyopathy, DCM; 6 with ischemic cardiomyopathy, ICM) tissue specimens of left ventricles were collected at LVAD implantation and afterwards at receiver heart explantation, respectively...
March 15, 2018: Heart and Vessels
Shelby Meier, Assaf A Gilad, J Anthony Brandon, Chenghao Qian, Erhe Gao, Jose F Abisambra, Moriel Vandsburger
Research into gene therapy for heart failure has gained renewed interest as a result of improved safety and availability of adeno-associated viral vectors (AAV). While magnetic resonance imaging (MRI) is standard for functional assessment of gene therapy outcomes, quantitation of gene transfer/expression relies upon tissue biopsy, fluorescence or nuclear imaging. Imaging of gene expression through the use of genetically encoded chemical exchange saturation transfer (CEST)-MRI reporter genes could be combined with clinical cardiac MRI methods to comprehensively probe therapeutic gene expression and subsequent outcomes...
March 15, 2018: Scientific Reports
Benedikt Schrage, Daniel Kalbacher, Michael Schwarzl, Nicole Rübsamen, Christoph Waldeyer, Peter Moritz Becher, Eike Tigges, Daniel Burkhoff, Stefan Blankenberg, Edith Lubos, Ulrich Schäfer, Dirk Westermann
BACKGROUND: Percutaneous mitral valve edge-to-edge repair (pMVR) with a MitraClip is beneficial for the clinical symptoms of patients irrespective of the ejection fraction (EF). Nevertheless, the consequences on hemodynamics are poorly understood. Therefore, we used data from noninvasive pressure-volume loops to investigate the left ventricular (LV) remodeling of patients after pMVR dependent on their baseline EF. METHODS AND RESULTS: In 130 patients with successful pMVR, the end-diastolic pressure-volume relationship (EDPVR) and end-systolic pressure-volume relationship were estimated noninvasively from echocardiographic data...
March 15, 2018: Journal of the American Heart Association
Felix Kreidel, Hannes Alessandrini, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
OBJECTIVE: To assess the results of catheter-based and surgical reintervention in primary mitral regurgitation (PMR) after failed MitraClip therapy. METHODS: We report on 21 consecutive symptomatic patients with PMR (median age 78 years) who underwent either repeat MitraClip therapy (n=7) or mitral valve surgery (n=14) after failure of the index procedure with 1-2 MitraClip implantations. At the time of reinterventions, 193 [IQR: 32 to 622] days after index procedure, patients had recurrent or persistent grade 3 MR...
March 12, 2018: Seminars in Thoracic and Cardiovascular Surgery
Eva Gerdts, Raffaele Izzo, Costantino Mancusi, Maria Angela Losi, Maria Virginia Manzi, Grazia Canciello, Nicola De Luca, Bruno Trimarco, Giovanni de Simone
BACKGROUND: In general, women have lower risk for cardiovascular disease. We tested whether this sex-specific protection persists also in the presence of hypertensive left ventricular hypertrophy (LVH). METHODS: 12,329 women and men with hypertension and free from prevalent cardiovascular disease enrolled in the prospective Campania Salute Network registry were followed over a median of 4.1years. Subjects were grouped according to the absence or the presence of LVH identified by echocardiography using validated sex-specific cut-off values of LV mass index (>47g/m2...
May 1, 2018: International Journal of Cardiology
Andrew R Kompa, Jiayu Lu, Thomas J Weller, Darren J Kelly, Henry Krum, Thomas G von Lueder, Bing H Wang
BACKGROUND: Angiotensin receptor neprilysin inhibitor (ARNi) enhances beneficial natriuretic peptides by inhibiting their breakdown through neprilysin. Although the first-in-class ARNi sacubitril/valsartan (LCZ696) reduced mortality and morbidity in heart failure (HF) with reduced ejection fraction (EF) compared to angiotensin converting enzyme inhibitor (ACEi), mechanistic data on ARNi are scarce. ARNi may be superior to ACEi in attenuating adverse cardiac remodeling and dysfunction post-myocardial infarction (MI)...
May 1, 2018: International Journal of Cardiology
Volkmar Müller, Michael Clemens, Jacek Jassem, Nedal Al-Sakaff, Petra Auclair, Eveline Nüesch, Debbie Holloway, Mona Shing, Yung-Jue Bang
BACKGROUND: Trastuzumab (Herceptin® [H]) is the standard of care for HER2-positive locally advanced/metastatic breast cancer and gastric/gastroesophageal junction (GEJ) cancer. However, there is a paucity of data available on long-term H treatment of patients. The Rollover Protocol (ROP) Study was conducted to report safety data for patients with HER2-positive locally advanced/metastatic breast and gastric/GEJ cancer who have received long-term H therapy (≥ 5 years and ≥ 3 years for breast and gastric/GEJ cancer, respectively)...
March 15, 2018: BMC Cancer
Susanne Röger, Stefanie L Rosenkaimer, Anna Hohneck, Siegfried Lang, Ibrahim El-Battrawy, Boris Rudic, Erol Tülümen, Ksenija Stach, Jürgen Kuschyk, Ibrahim Akin, Martin Borggrefe
BACKGROUND: The wearable cardioverter-defibrillator (WCD) has emerged as a valuable tool to temporarily protect patients at risk for sudden cardiac death (SCD). The aim of this study was to determine the value of the WCD for therapy optimization of heart failure patients. METHODS: One hundred five consecutive patients that received WCD between 4/2012 and 9/2016 were included in the study. All patients were followed for clinical outcome and echocardiographic parameters during WCD therapy and had continued follow-up after WCD therapy, irrespective of subsequent implantable cardioverter-defibrillator (ICD) implantation...
March 15, 2018: BMC Cardiovascular Disorders
Nazmi Narin, Ozge Pamukcu, Aydin Tuncay, Ali Baykan, Suleyman Sunkak, Onur Tasci, Kazim Uzum, Levent Saltık
Untreated ventricular septal defect (VSD) is an important cause of congestive heart failure in early infancy. Growth is impaired in this population, and surgical closure is challenging because of congestion in the lungs, making infants prone to respiratory infection, and because of their poor nutritional status. The aim of this study is to share our experience with percutaneous VSD closure in patients under 1 year of age. Patients with hemodynamically significant left-to-right shunt, less than 1 year of age, and with VSD diameter ≤ 6 mm were retrospectively included in the study between December 2014 and January 2017...
March 15, 2018: Pediatric Cardiology
Rebecca R Vanderpool, Melissa Saul, Mehdi Nouraie, Mark T Gladwin, Marc A Simon
Importance: Heart failure with preserved ejection fraction (HFpEF) is highly prevalent, yet there are no specific therapies, possibly due to phenotypic heterogeneity. The development of pulmonary hypertension (PH) in patients with HFpEF is considered a high-risk phenotype in need of targeted therapies, but there have been limited hemodynamic and outcomes data. Objective: To identify the hemodynamic characteristics and outcomes of PH-HFpEF. Design, Setting, and Participants: Cohort study of participants who had a right heart catheterization from January 2005 to September 2012 (median [interquartile range] follow-up time, 1578 [554-2513] days) were analyzed...
March 14, 2018: JAMA Cardiology
Denisa Muraru, Alice Niero, Hugo Rodriguez-Zanella, Diana Cherata, Luigi Badano
Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is an advanced imaging technique designed for left ventricular (LV) myocardial deformation analysis based on 3D data sets. 3DSTE has the potential to overcome some of the intrinsic limitations of two-dimensional STE (2DSTE) in the assessment of complex LV myocardial mechanics, offering additional deformation parameters (such as area strain) and a comprehensive quantitation of LV geometry and function from a single 3D acquisition. Albeit being a relatively young technique still undergoing technological developments, several experimental studies and clinical investigations have already demonstrated the reliability and feasibility of 3DSTE, as well as several advantages of 3DSTE over 2DSTE...
February 2018: Cardiovascular Diagnosis and Therapy
Heidi J Reich, Lawrence S C Czer, Danny Ramzy, Francisco Arabia, Jaime Moriguchi, Deborah D Ascheim, Timothy D Henry
The use of stem cell therapy in combination with a left ventricular assist device (LVAD) for patients with advanced heart failure (HF) is an attractive concept with the potential to alter the natural history of HF. Cell therapy trials for HF have demonstrated excellent safety and encouraging results, but current rates of myocardial recovery after LVAD implantation are limited. Early trials combining these 2 therapies to increase the likelihood of recovery and to potentially obviate the need for subsequent transplantation appear promising...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
David M Tehrani, Daniel Rodgers, Sirtaz Adatya, Nitasha Sarswat, Jayant Raikhelkar, Gene H Kim, Gabriel Sayer, Nir Uriel
We aim to evaluate the echocardiographic/hemodynamic effects of left ventricular assist devices in African American (AA) versus non-AA patients undergoing ramp speed optimization and its subsequent effect on readmissions. In 65 patients (26 AA), no differences in baseline echocardiographic/hemodynamic parameters were noted. During ramp testing, there was a significantly greater increase in cardiac output (slope: 0.29 ± 0.24 vs. 0.15 ± 0.12, p < 0.01) with more rapid decrease in left ventricular end-diastolic diameter (slope: -0...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Giacomo Veronese, Enrico Ammirati, Manlio Cipriani, Maria Frigerio
Myocarditis is an inflammatory disease of the myocardium with a broad spectrum of clinical presentations, ranging from mild symptoms to severe heart failure. The course of patients with myocarditis is heterogeneous, varying from partial or full clinical recovery in few days to advanced low cardiac output syndrome requiring mechanical circulatory support or heart transplantation. Fulminant myocarditis (FM) is a peculiar clinical condition and is an acute form of myocarditis, whose main characteristic is a rapidly progressive clinical course with the need for hemodynamic support...
March 13, 2018: Anatolian Journal of Cardiology
Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano
BACKGROUND: Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. METHODS: We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA)...
March 10, 2018: Lancet
Claudio de Lucia, Giuseppina Gambino, Laura Petraglia, Andrea Elia, Klara Komici, Grazia Daniela Femminella, Maria Loreta D'Amico, Roberto Formisano, Giulia Borghetti, Daniela Liccardo, Maria Nolano, Steven R Houser, Dario Leosco, Nicola Ferrara, Walter J Koch, Giuseppe Rengo
BACKGROUND: Caloric restriction (CR) has been described to have cardioprotective effects and improve functional outcomes in animal models and humans. Chronic ischemic heart failure (HF) is associated with reduced cardiac sympathetic innervation, dysfunctional β-adrenergic receptor signaling, and decreased cardiac inotropic reserve. We tested the effects of a long-term CR diet, started late after myocardial infarction on cardiac function, sympathetic innervation, and β-adrenergic receptor responsiveness in a rat model of postischemic HF...
March 2018: Circulation. Heart Failure
Kay Lash, Rachelle Oppel, Jeanette Hasse
Technology advances have made it possible to prolong life for patients with heart failure who are not transplant candidates or while awaiting transplant. Many different cardiac devices are available that can be used as a bridge to transplant (temporary support) or as a destination therapy (permanent support). Placement of these devices can cause complications that, if not addressed, could negatively impact the nutrition status of patients. Placement of nasointestinal feeding tubes using an electromagnetic sensor-guided enteral access system (EMS-EAS) has been difficult in patients with implantable devices because of the potential for interference with the EMS-EAS and the left ventricular assist device (LVAD)...
March 12, 2018: Nutrition in Clinical Practice
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