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https://www.readbyqxmd.com/read/29150999/focus-on-focus-lack-of-coherence-between-systemic-and-microvascular-indices-of-edema-formation
#1
Birkitt Ten Tusscher, Corien Gudden, Suus van Vliet, Bob Smit, Can Ince, E Christiaan Boerma, Harm-Jan S de Grooth, Paul W G Elbers
BACKGROUND: Fluid therapy remains a cornerstone of therapy in shock states. However, fluid overloading ultimately results in edema formation which is related to excess morbidity and mortality. Handheld microscopes are now frequently used to study the sublingual microcirculation. As a corollary, these devices measure focal distance, or surface to capillary distance. Physiologically, this could represent a microvascular index of edema formation and could have the potential to guide fluid therapy...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29150426/long-term-outcomes-in-patients-with-type-2-myocardial-infarction-and-myocardial-injury
#2
Andrew R Chapman, Anoop S V Shah, Kuan Ken Lee, Atul Anand, Oliver Francis, Philip Adamson, David A McAllister, Fiona Strachan, David E Newby, Nicholas L Mills
Background -Type 2 myocardial infarction and myocardial injury are common in clinical practice, but long-term consequences are uncertain. We aimed to define long-term outcomes and explore risk stratification in patients with type 2 myocardial infarction and myocardial injury. Methods -We identified consecutive patients (n=2,122) with elevated cardiac troponin I concentrations (≥0.05 μg/L) at a tertiary cardiac center. All diagnoses were adjudicated as per the Universal Definition of Myocardial Infarction...
November 17, 2017: Circulation
https://www.readbyqxmd.com/read/29150159/diagnostic-performance-of-pulmonary-capacitance-at-rest-and-during-exercise-in-idiopathic-pulmonary-arterial-hypertension
#3
Pankaj Jain, Sriram Rao, Peter Macdonald, Eugene Kotlyar, Andrew Jabbour, Christopher Hayward, Anne Keogh
BACKGROUND: Reliable markers of early disease are needed in pulmonary arterial hypertension (PAH). As measures of the contribution of abnormal vascular compliance to overall vascular resistance, resting and exercise pulmonary capacitance-defined as the stroke volume divided by the change in pulmonary pulse pressure-may be sensitive markers of early disease. METHODS: We examined all patients in our pulmonary hypertension database with idiopathic PAH, who had undergone rest and exercise right heart catheterisation in one sitting...
November 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29149974/liver-transplantation-with-old-grafts-a-ten-year-experience
#4
S Roullet, M Defaye, A Quinart, J-P Adam, L Chiche, C Laurent, M Neau-Cransac
BACKGROUND: The persistent scarcity of donors has prompted liver transplantation teams to find solutions for increasing graft availability. We report our experience of liver transplantations performed with grafts from older donors, specifically over 70 and 80 years old. PATIENTS AND METHODS: We analyzed our prospectively maintained single-center database from January 1, 2005, to December 31, 2014, with 380 liver transplantations performed in 354 patients. Six groups were composed according to donor age: <40 (n = 84), 40 to 49 (n = 67), from 50 to 59 (n = 62), from 60 to 69 (n = 76), from 70 to 79 (n = 64), and ≥80 years (n = 27)...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#5
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29147768/non-invasive-methods-for-estimating-mpap-in-copd-using-cardiovascular-magnetic-resonance-imaging
#6
C S Johns, S Rajaram, D A Capener, C Oram, C Elliot, R Condliffe, D G Kiely, J M Wild, A J Swift
PURPOSE: Pulmonary hypertension (PH) is associated with a poor outcome in chronic obstructive pulmonary disease (COPD) and is diagnosed invasively. We aimed to assess the diagnostic accuracy and prognostic value of non-invasive cardiovascular magnetic resonance (CMR) models. METHODS: Patients with COPD and suspected PH, who underwent CMR and right heart catheter (RHC) were identified. Three candidate models were assessed: 1, CMR-RV model, based on right ventricular (RV) mass and interventricular septal angle; 2, CMR PA/RV includes RV mass, septal angle and pulmonary artery (PA) measurements; 3, the Alpha index, based on RV ejection fraction and PA size...
November 16, 2017: European Radiology
https://www.readbyqxmd.com/read/29147474/new-onset-of-insomnia-in-hospitalized-patients-in-general-medical-wards-incidence-causes-and-resolution-rate
#7
An Ho, Bronson Raja, Richard Waldhorn, Valentina Baez, Idiris Mohammed
Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146865/echocardiographic-changes-with-non-invasive-ventilation-and-cpap-in-obesity-hypoventilation-syndrome
#8
Jaime Corral, Maria Victoria Mogollon, M-Ángeles Sánchez-Quiroga, Javier Gómez de Terreros, Auxiliadora Romero, Candela Caballero, Joaquin Teran-Santos, María L Alonso-Álvarez, Teresa Gómez-García, Mónica González, Soledad López-Martínez, Pilar de Lucas, José M Marin, Odile Romero, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Roberto M Lang, Babak Mokhlesi, Juan F Masa
RATIONALE: Despite a significant association between obesity hypoventilation syndrome (OHS) and cardiac dysfunction, no randomised trials have assessed the impact of non-invasive ventilation (NIV) or CPAP on cardiac structure and function assessed by echocardiography. OBJECTIVES: We performed a secondary analysis of the data from the largest multicentre randomised controlled trial of OHS (Pickwick project, n=221) to determine the comparative efficacy of 2 months of NIV (n=71), CPAP (n=80) and lifestyle modification (control group, n=70) on structural and functional echocardiographic changes...
November 16, 2017: Thorax
https://www.readbyqxmd.com/read/29146614/heart-rate-reduction-improves-biventricular-function-and-interactions-in-experimental-pulmonary-hypertension
#9
Olga Gomez, Kenichi Okumura, Osami Honjo, Mei Sun, Ryo Ishii, Bart Bijens, Mark K Friedberg
OBJECTIVES: To investigate mechanisms of heart rate (HR) reduction on biventricular function and interactions in experimental pulmonary arterial hypertension (PAH). METHODS: We compared cardiac-cycle mechanics and interventricular interactions in 15 sham, 8 monocrotaline-PAH, 9 PAH+carvedilol and 8 PAH+ivabradine rats. We used echocardiography to assess biventricular function, timing of cardiac- cycle events and septal position in PAH rats; and related HR reduction effect on biventricular function measured by echocardiography and conductance catheter...
November 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29146612/derivation-and-validation-of-a-geriatric-sensitive-perioperative-cardiac-risk-index
#10
Rami Alrezk, Nicholas Jackson, Mohanad Al Rezk, Robert Elashoff, Nancy Weintraub, David Elashoff, Gregg C Fonarow
BACKGROUND: Surgical patients aged 65 and over face a higher risk of cardiac complications from noncardiac surgery. The Revised Cardiac Risk Index (RCRI) and the Gupta Myocardial Infarction or Cardiac Arrest (MICA) calculator are widely used to predict this risk, but they are not specifically designed to predict MICA in geriatric patients. Our hypothesis is that a new geriatric-sensitive index, derived from geriatric data, will capture this population's unique response to risk factors...
November 16, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29146587/prognostic-stratification-of-patients-with-st-segment-elevation-myocardial-infarction-prospect-a-cardiac-magnetic-resonance-study
#11
Gianluca Pontone, Andrea I Guaricci, Daniele Andreini, Giovanni Ferro, Marco Guglielmo, Andrea Baggiano, Laura Fusini, Giuseppe Muscogiuri, Valentina Lorenzoni, Saima Mushtaq, Edoardo Conte, Andrea Annoni, Alberto Formenti, Maria Elisabetta Mancini, Patrizia Carità, Massimo Verdecchia, Silvia Pica, Fabio Fazzari, Nicola Cosentino, Giancarlo Marenzi, Mark G Rabbat, Piergiuseppe Agostoni, Antonio L Bartorelli, Mauro Pepi, Pier Giorgio Masci
BACKGROUND: Cardiac magnetic resonance (CMR) is a robust tool to evaluate left ventricular ejection fraction (LVEF), myocardial salvage index, microvascular obstruction, and myocardial hemorrhage in patients with ST-segment-elevation myocardial infarction. We evaluated the additional prognostic benefit of a CMR score over standard prognostic stratification with global registry of acute coronary events (GRACE) score and transthoracic echocardiography LVEF measurement. METHODS AND RESULTS: Two hundred nine consecutive patients with ST-segment-elevation myocardial infarction (age, 61...
November 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29146543/cardiac-resynchronization-therapy-optimisation-of-interventricular-delay-by-the-systolic-dyssynchrony-index-a-comparative-randomized-12-month-follow-up-study
#12
Jiri Vondrak, Dan Marek, Jan Vecera, Klara Benesova, Jan Matejka
BACKGROUND: The aim of our study was to compare the effect of interventricular (VV) delay optimisation in CRT recipients based on systolic dyssynchrony index (SDI) derived from the three-dimensional echocardiography (3DE) versus QRS width assessment, on left ventricle volume reduction at the 12-month follow-up. METHODS: We included 63 patients with recently implanted CRT in this randomized, open-label trial. Patients were randomized to VV delay optimisation based on QRS complex width measurement in the group 1 (n=31) to obtain the narrowest QRS complex and based on SDI in group 2 (n=32) to achieve its lowest possible value...
November 13, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29146481/central-obesity-is-the-key-component-in-the-association-of-metabolic-syndrome-with-left-ventricular-global-longitudinal-strain-impairment
#13
Wilson Cañon-Montañez, Angela B S Santos, Lisandra A Nunes, Julio C G Pires, Claudia M V Freire, Antonio L P Ribeiro, José G Mill, Marina Bessel, Bruce B Duncan, Maria Inês Schmidt, Murilo Foppa
INTRODUCTION AND OBJECTIVES: Subclinical systolic dysfunction is one of the proposed mechanisms for increased cardiovascular risk associated with metabolic syndrome (MS). This study investigated the association between MS and impaired left ventricular global longitudinal strain (GLS) and the role of each MS criteria in this association. METHODS: We analyzed a random sample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) after excluding participants with prevalent heart disease...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29146296/anomalous-origin-of-coronary-arteries-from-the-wrong-sinus-in-athletes-diagnosis-and-management-strategies
#14
Vincenzo Palmieri, Salvatore Gervasi, Massimiliano Bianco, Roberta Cogliani, Barbara Poscolieri, Francesco Cuccaro, Riccardo Marano, Mario Mazzari, Cristina Basso, Paolo Zeppilli
AIMS: Although anomalous origin of left (AOLCA) and right coronary artery (AORCA) from the wrong sinus may cause sudden death (SD) in athletes, early diagnosis and management of these anomalies are still challenging. We analysed clinical/instrumental profiles of athletes identified with AOLCA/AORCA focusing our attention on diagnosis, management and follow-up. METHODS AND RESULTS: We report 23 athletes (17 males, mean age 27±17yrs.), 6 with AOLCA and 17 with AORCA...
November 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29146023/longitudinal-associations-of-pericardial-and-intrathoracic-fat-with-progression-of-coronary-artery-calcium-from-the-framingham-heart-study
#15
Jane J Lee, Alison Pedley, Udo Hoffmann, Joseph M Massaro, Christopher J O'Donnell, Emelia J Benjamin, Michelle T Long
Cross-sectional studies have shown that pericardial fat is associated with atherosclerotic burden above and beyond generalized and central adiposity. Whether pericardial fat is longitudinally associated with coronary artery calcium (CAC) has not been firmly established. We examined the associations between cardiac ectopic fat including pericardial and intrathoracic fat with CAC progression and incidence in a community-based study setting. Study participants were from the Framingham Heart Study Offspring and Third Generation Cohorts who underwent multidetector computed tomography at 2 consecutive examinations (2002 to 2005 and 2008 to 2011) for the assessment of CAC...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29145722/outcomes-of-beating-heart-on-pump-utilizing-a-miniature-bypass-circuit-versus-off-pump-cardiac-bypass-at-a-veterans-affairs-medical-center
#16
Matthew Skancke, Kendal Endicott, Richard Amdur, Michael Greenberg, Gregory Trachiotis
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) helps reduce systemic inflammatory changes by maintaining native pulsatile flow. This analysis evaluates the outcomes of OPCAB at a Veterans Affairs Medical Center (VAMC) and evaluates the use of beating heart on-pump (BHOP) bypass grafting as an empiric therapy for high-risk patients. METHODS: We performed a retrospective analysis of 756 patients who underwent coronary bypass grafting between 2004-2015 at a single VAMC...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29145434/is-the-euroscore-ii-reliable-to-estimate-operative-mortality-among-octogenarians
#17
Sophie Provenchère, Arnaud Chevalier, Walid Ghodbane, Claire Bouleti, Philippe Montravers, Dan Longrois, Bernard Iung
OBJECTIVES: Concerns have been raised about the predictive performance (PP) of the EuroSCORE I (ES I) to estimate operative mortality (OM) of patients aged ≥80. The EuroSCORE II (ES II) has been described to have better PP of OM but external validations are scarce. Furthermore, the PP of ES II has not been investigated among the octogenarians. The goal of the study was to compare the PP of ES II and ES I among the overall population and patients ≥ 80. METHODS: The ES I and ES II were computed for 7161 consecutive patients who underwent major cardiac surgery in a 7-year period...
2017: PloS One
https://www.readbyqxmd.com/read/29143384/enhanced-ventricular-arterial-coupling-during-a-2-year-physical-activity-program-in-patients-with-rheumatoid-arthritis
#18
Philip Sarajlic, Cecilia Fridén, Lars H Lund, Aristomenis Manouras, Ashwin Venkateshvaran, Susanna C Larsson, Birgitta Nordgren, Christina H Opava, Ingrid E Lundberg, Magnus Bäck
OBJECTIVE: To establish how guided physical activity in patients with rheumatoid arthritis (RA) without known cardiovascular disease affected vascular and cardiac function, and how these two entities were prospectively interconnected in this patient group. METHODS: Prospective substudy of 29 participants in the Physical Activity in RA (PARA) 2010 trial. All subjects were examined at baseline, at year 1 and 2 with measures of pulse wave velocity and arterial augmentation index, as well as echocardiographic evaluation of diastolic parameters and ventricular-arterial coupling...
November 15, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29143104/left-ventricular-end-diastolic-dimension-and-septal-e-are-predictors-of-cardiac-index-at-rest-while-tricuspid-annular-plane-systolic-excursion-is-a-predictor-of-peak-oxygen-uptake-in-patients-with-pulmonary-hypertension
#19
Yoshihisa Nakano, Naoki Okumura, Shiro Adachi, Shigetake Shimokata, Fumitaka Tajima, Yoshihiro Kamimura, Toyoaki Murohara, Takahisa Kondo
Little is known regarding a correlation of hemodynamics at rest or exercise capacity with echocardiographic parameters in patients with pulmonary hypertension (PH). To clarify these potential correlations, we performed transthoracic echocardiography, right heart catheterization, and cardiopulmonary exercise testing in 53 patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Left ventricular end-diastolic dimension (LVDd), early diastolic velocity of the septal mitral annulus (septal e'), tricuspid regurgitation peak gradient (TRPG), and tricuspid annular plane systolic excursion (TAPSE) were significantly correlated with cardiac index (LVDd; r = 0...
November 15, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29143103/combined-assessment-of-left-ventricular-end-diastolic-pressure-and-ejection-fraction-by-left-ventriculography-predicts-long-term-outcomes-of-patients-with-st-segment-elevation-myocardial-infarction
#20
Daiga Saito, Rine Nakanishi, Ippei Watanabe, Takayuki Yabe, Ryo Okubo, Hideo Amano, Mikihito Toda, Takanori Ikeda
In patients with ST-segment elevation myocardial infarction (STEMI), it is unclear if combined assessment of left ventricular end-diastolic pressure (LVEDP) and left ventricular ejection fraction (LVEF) improves prediction of major adverse cardiac events (MACE). We analyzed data from 266 STEMI patients who underwent successful percutaneous coronary intervention and subsequent left ventriculography (LVG). Patients were divided into 4 groups, as follows: Group 1, LVEDP < 21 mmHg and LVEF ≥ 55%; Group 2, LVEDP < 21 mmHg and LVEF < 55%; Group 3, LVEDP ≥ 21 mmHg and LVEF ≥ 55%; and Group 4, LVEDP ≥ 21 mmHg and LVEF < 55%...
November 15, 2017: Heart and Vessels
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