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https://www.readbyqxmd.com/read/27912902/evolution-of-the-clinical-profile-of-patients-with-acute-heart-failure-treated-in-spanish-emergency-departments
#1
R Escoda, Ò Miró, F J Martín-Sánchez, J Jacob, P Herrero, V Gil, J M Garrido, M J Pérez-Durá, M Fuentes, P Llorens
OBJECTIVE: To analyse the changes in epidemiology, outpatient and emergency department clinical care, and outcomes of patients treated for acute heart failure (AHF) in Spanish hospital emergency departments (HEDs) between 2007 and 2014. METHOD: A multicentre cohort study was conducted that consecutively included patients with AHF diagnosed in 9HEDs during 4 periods (2007, 2009, 2011 and 2014). The study analysed the changes observed in 20 variables corresponding to baseline data, outpatient care and emergency care data and outcome data...
November 29, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27909476/atrial-fibrillation-and-risk-of-dementia-cognitive-decline
#2
REVIEW
Anand D Shah Md, Faisal M Merchant Md, David B Delurgio Md
Emerging evidence suggests a link between atrial fibrillation and subsequent development of dementia. While a majority of risk can be attributed to cardioembolic stroke secondary to atrial fibrillation, additional risk is apparent, and may be driven by vascular inflammation and changes in cerebral perfusion. Medical therapies including anticoagulation, statin therapy, and angiotensin-renin-aldosterone axis antagonists may reduce dementia risk. Procedural therapies such as atrial fibrillation catheter ablation and left atrial appendage closure may also prove to be important mediators of acute and long-term risk...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27899856/effect-of-spironolactone-on-plasma-apelin-12-levels-in-patients-with-chronic-systolic-heart-failure
#3
Mustafa Topuz, Mehmet Cosgun, Oğuz Akkuş, Atilla Bulut, Omer Sen, Ayşe Nur Topuz, Murat Caylı
BACKGROUND: The aim of this study was to determine whether spironolactone therapy has an effect on serum apelin-12 levels in heart failure with reduced ejection fraction (HFrEF) patients. METHODS: Eighty outpatients previously diagnosed with HFrEF were enrolled in the current study. Included patients were taking only standard heart failure therapy (ST) (angiotensin converting enzyme or angiotensin receptor blocker, beta-blockers, loop diuretics and anticoagulant or antiagregan agents) without a mineralocorticoid receptor antagonists (MRA) because of its side effects, and were designated the non-MRA group; those patients taking 25 mg/daily spironolactone in addition to the ST were deemed the MRA group...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27893293/prevelence-of-primary-aldosteronism-in-an-urban-hypertensive-population
#4
Sandi-Jo Galati, Khadeen C Cheesman, Ryan Springer-Miller, Sarah M Hopkins, Lawrence Krakoff, Emilia Bagiella, Rachel A Zhuk, Tiffany K Ying, Chelsey Amer, Michael K Boyajian, W B Inabnet, Alice C Levine
OBJECTIVE: To determine the prevalence of primary aldosteronism (PA) in hypertensive patients presenting to the primary care clinic at The Mount Sinai Hospital, regardless of the degree of hypertension and to identify clinical criteria that should prompt screening for PA. METHODS: An aldosterone:renin ratio (ARR, cutoff ≥20, with plasma aldosterone concentration [PAC] ≥10 and suppressed renin) was used to prospectively screen 296 hypertensive patients (blood pressure [BP] ≥140/90) over the age of 18 from August 2012 through May 2013...
November 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27892684/angiotensin-receptor-neprilysin-inhibitor-lcz696-pharmacology-pharmacokinetics-and-clinical-development
#5
Yue Hua, Ian Wang, Bin Liu, Darren J Kelly, Christopher Reid, Danny Liew, Yingchun Zhou, Bing H Wang
Heart failure still has a significant disease burden with poor outcomes worldwide despite advances in therapy. The standard therapies have been focused on blockade of renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and mineralocorticoid antagonists and the sympathetic nervous system with β-blockers. The natriuretic peptide system is a potential counter-regulatory system that promotes vasodilatation and natriuresis. Angiotensin receptor neprilysin inhibitors are a new class drug capable of blocking the renin-angiotensin-aldosterone system and enhancing the natriuretic peptide system to improve neurohormonal balance...
November 28, 2016: Future Cardiology
https://www.readbyqxmd.com/read/27881412/renin-angiotensin-aldosterone-system-inhibitors-improve-membrane-stability-and-change-gene-expression-profiles-in-dystrophic-skeletal-muscles
#6
Jessica A Chadwick, Sayak Bhattacharya, Jeovanna Lowe, Noah Weisleder, Jill A Rafael-Fortney
Angiotensin-converting enzyme inhibitors and mineralocorticoid receptor (MR) antagonists are FDA approved drugs that inhibit the renin-angiotensin-aldosterone system (RAAS) and are used to treat heart failure. Combined treatment with the angiotensin-converting enzyme inhibitor lisinopril and the non-specific MR antagonist spironolactone surprisingly improves skeletal muscle, in addition to heart function and pathology in a Duchenne muscular dystrophy mouse model. We recently demonstrated that MR is present in all limb and respiratory muscles and functions as a steroid hormone receptor in differentiated normal human skeletal muscle fibers...
November 23, 2016: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/27866868/lack-of-evidence-of-lower-30-day-all-cause-readmission-in-medicare-beneficiaries-with-heart-failure-and-reduced-ejection-fraction-discharged-on-spironolactone
#7
Phillip H Lam, Daniel J Dooley, Chakradhari Inampudi, Cherinne Arundel, Gregg C Fonarow, Javed Butler, Wen-Chih Wu, Marc R Blackman, Markus S Anker, Prakash Deedwania, Michel White, Sumanth D Prabhu, Charity J Morgan, Thomas E Love, Wilbert S Aronow, Richard M Allman, Ali Ahmed
BACKGROUND: Therapy with evidence-based heart failure (HF) medications has been shown to be associated with lower risk of 30-day all-cause readmission in patients with HF and reduced ejection fraction (HFrEF). METHODS: We examined the association of aldosterone antagonist use with 30-day all-cause readmission in this population. Of the 2443 Medicare beneficiaries with HF and left ventricular EF ≤35% discharged home from 106 Alabama hospitals during 1998-2001, 2060 were eligible for spironolactone therapy (serum creatinine ≤2...
November 4, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27856806/comparative-effectiveness-of-fourth-line-anti-hypertensive-agents-in-resistant-hypertension-a-systematic-review-and-meta-analysis
#8
REVIEW
Sarah-Jo Sinnott, Laurie A Tomlinson, Adrian A Root, Rohini Mathur, Kathryn E Mansfield, Liam Smeeth, Ian J Douglas
AIM: We assessed the effectiveness of fourth-line mineralocorticoid receptor antagonists in comparison with other fourth-line anti-hypertensive agents in resistant hypertension. METHODS AND RESULTS: We systematically searched Medline, EMBASE and the Cochrane library from database inception until January 2016. We included randomised and non-randomised studies that compared mineralocorticoid receptor antagonists with other fourth-line anti-hypertensive agents in patients with resistant hypertension...
November 17, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27849367/fetal-exposure-to-low-levels-of-the-plasticizer-dehp-predisposes-the-adult-male-adrenal-gland-for-endocrine-disruption
#9
S Lee, D B Martinez-Arguelles, E Campioli, V Papadopoulos
In utero exposure to endocrine disrupting chemicals (EDCs) may affect adult health. Di-(2-ethylhexyl) phthalate (DEHP) is an EDC widely used in the production of polyvinyl chloride products and an ubiquitous environmental contaminant. Previously, we used a rat model system to show that fetal exposure to DEHP decreased levels of major steroid hormones in adulthood and that environmentally-relevant levels of DEHP affected both gene expression and epigenomic loci that were affected by exposure to high levels. In the adrenal gland, we reported that the peroxisome proliferator-activated receptor (PPAR) and cholesterol biosynthesis pathways were sensitive targets of DEHP...
November 16, 2016: Endocrinology
https://www.readbyqxmd.com/read/27815032/pharmacological-therapy-for-the-prevention-and-management-of-cardiomyopathy-in-duchenne-muscular-dystrophy-a-systematic-review
#10
Basmah El-Aloul, Luis Altamirano-Diaz, Eugenio Zapata-Aldana, Rebecca Rodrigues, Monali S Malvankar-Mehta, Cam-Tu Nguyen, Craig Campbell
Cardiomyopathy is a major source of morbidity and mortality in Duchenne muscular dystrophy (DMD) patients now that respiratory care has improved. There is currently no definitive evidence guiding the management of DMD-associated cardiomyopathy (DMD-CM). The objective of this systematic review was to evaluate the effectiveness of pharmacotherapies for the prevention and/or management of DMD-CM and to determine the optimal timing to commence these interventions. A systematic search was conducted in January 2016 using MEDLINE, EMBASE and CINAHL databases and grey literature sources for studies evaluating the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, beta-blockers or aldosterone antagonists...
October 11, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27812391/use-of-aldosterone-antagonist-to-treat-diarrhea-and-hypokalemia-of-ogilvie-s-syndrome
#11
Pradhum Ram, Abhinav Goyal, Marvin Lu, Joshua Sloan, William McElhaugh
Ogilvie's syndrome (OS) is a functional obstruction of the bowel due to an autonomic imbalance. It often presents with diarrhea and is associated with hypokalemia. We present a case of a 70-year-old male who developed severe abdominal distension, watery diarrhea, and persistent hypokalemia status after left hip arthroplasty after suffering from a femoral neck fracture due to a fall and was diagnosed with OS. The persistent hypokalemia was slow to improve despite aggressive repletion because of the high potassium losses in the stool...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27810862/dual-endothelin-a-endothelin-b-receptor-blockade-and-cardiac-remodeling-in-heart-failure-with-preserved-ejection-fraction
#12
Maria Valero-Munoz, Shanpeng Li, Richard M Wilson, Batbold Boldbaatar, Marc Iglarz, Flora Sam
BACKGROUND: Despite the increasing prevalence of heart failure with preserved ejection fraction (HFpEF) in humans, there remains no evidence-based therapies for HFpEF. Endothelin-1 (ET-1) antagonists are a possibility because elevated ET-1 levels are associated with adverse cardiovascular effects, such as arterial and pulmonary vasoconstriction, impaired left ventricular (LV) relaxation, and stimulation of LV hypertrophy. LV hypertrophy is a common phenotype in HFpEF, particularly when associated with hypertension...
November 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27798095/myeloid-cells-are-capable-of-synthesizing-aldosterone-to-exacerbate-damage-in-muscular-dystrophy
#13
Jessica A Chadwick, Sarah A Swager, Jeovanna Lowe, Steven S Welc, James G Tidball, Celso E Gomez-Sanchez, Elise P Gomez-Sanchez, Jill A Rafael-Fortney
FDA-approved mineralocorticoid receptor (MR) antagonists are used to treat heart failure. We have recently demonstrated efficacy of MR antagonists for skeletal muscles in addition to heart in Duchenne muscular dystrophy mouse models and that mineralocorticoid receptors are present and functional in skeletal muscles. The goal of this study was to elucidate the underlying mechanisms of MR antagonist efficacy on dystrophic skeletal muscles. We demonstrate for the first time that infiltrating myeloid cells clustered in damaged areas of dystrophic skeletal muscles have the capacity to produce the natural ligand of MR, aldosterone, which in excess is known to exacerbate tissue damage...
October 23, 2016: Human Molecular Genetics
https://www.readbyqxmd.com/read/27790455/efficacy-and-safety-of-complete-raas-blockade-with-aliskiren-in-patients-with-refractory-proteinuria-who-were-already-on-combined-ace-inhibitor-arb-and-aldosterone-antagonist
#14
Prabitha Panattil, M Sreelatha
INTRODUCTION: Proteinuria is always associated with intrinsic kidney disese and is a strong predictor of later development of End Stage Renal Disease (ESRD). As Renin Angiotensin Aldosterone System (RAAS) has a role in mediating proteinuria, inhibitors of this system are renoprotective and patients with refractory proteinuria are put on a combination of these agents. The routinely employed triple blockade of RAAS with Angiotensin Converting Enzyme (ACE) inhibitor, ARB and Aldosterone antagonist has many limitations...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27787836/should-all-patients-with-resistant-hypertension-receive-spironolactone
#15
REVIEW
Ján Rosa, Tomáš Zelinka, Ondřej Petrák, Branislav Štrauch, Robert Holaj, Jiří Widimský
PURPOSE OF REVIEW: Resistant hypertension is a common clinical situation. Identification of true resistant hypertension (using 24-h ambulatory blood pressure monitoring to exclude white coat phenomenon, excluding secondary causes and non-adherence to treatment) is important mostly because of the application of a proper therapeutic approach and the higher cardiovascular risk of these patients. This review surveys recent studies, with a focus on mineralocorticoid receptor antagonists, including spironolactone, in the treatment of resistant hypertension...
November 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/27783554/is-the-currently-used-prescription-adjudication-date-a-good-proxy-for-calculating-medication-refill-adherence
#16
Corey A Lester, Kevin A Look, Michelle A Chui
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) adopted the proportion of days covered (PDC) calculation for use in their Five-Star Quality Rating System for Medicare Advantage and Prescription Drug Plans. This calculation uses the prescription adjudication date (i.e., date the prescription is billed to the benefits manager by a pharmacy) as a proxy for medication adherence. Adherence programs, such as automatic refill programs, have become commonplace in community pharmacy and have been identified by industry leaders as interfering with the ability to accurately measure adherence using PDC...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27777360/trends-in-antihypertensive-medication-use-among-us-patients-with-resistant-hypertension-2008-to-2014
#17
Andrew Y Hwang, Chintan Dave, Steven M Smith
Little is known of US trends in antihypertensive drug use for patients with treatment-resistant hypertension (TRH). We analyzed antihypertensive use among patients with TRH (treated with ≥4 antihypertensive drugs concurrently) from July 2008 through December 2014 using Marketscan administrative data. We included adults aged 18 to 65 years, with ≥6 months of continuous enrollment, a hypertension diagnosis, and ≥1 episode of overlapping use of ≥4 antihypertensive drugs; patients with heart failure were excluded...
October 24, 2016: Hypertension
https://www.readbyqxmd.com/read/27776721/primary-aldosteronism-diagnosis-and-management
#18
Geeta Gyamlani, Carol M Headley, Adnan Naseer, Ganpat S Valaulikar, Stephen A Geraci
Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Localization to determine adrenal gland involvement is done by imaging, with computerized tomography or magnetic resonance imaging...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27774257/the-appropriate-dose-of-angiotensin-converting-enzyme-inhibitors-or-angiotensin-receptor-blockers-in-patients-with-dilated-cardiomyopathy-the-higher-the-better
#19
Junichi Ishida, Masaaki Konishi, Stephan von Haehling
Heart failure is a major public issue, and dilated cardiomyopathy (DCM) is one of the common etiologies of heart failure. DCM is generally progressive, and some patients with DCM need heart transplant despite optimal medical and mechanical therapy. Current guidelines recommend inhibitors of renin-angiotensin-aldosterone system, namely angiotensin-converting-enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), and mineralocorticoid receptor antagonist as well as beta-blockers for the medical treatment of heart failure with reduced ejection fraction, including DCM...
December 2015: ESC Heart Failure
https://www.readbyqxmd.com/read/27771983/potassium-supplementation-and-long-term-outcomes-in-chronic-peritoneal-dialysis-patients-with-end-stage-renal-disease-a-propensity-score-matching-study
#20
Yun-Fang Zhang, Qi Wang, Yan-Yan Su, Shen Yang, Jian Guo, Jie Luo, Jia-Min Tang, Hong-Yan Li
OBJECTIVE: In this retrospective matched-cohort study, the association between potassium supplementation and long-term outcomes was determined. METHODS: Chronic peritoneal dialysis (PD) patients, aged ≥ 16 years, being referred to four PD centers in China, with serum potassium levels ≤ 3.5 mEq/L on three consecutive monthly in Q4 2008 and without receiving oral potassium supplementation in the prior three months were included in this study. Patients were divided into two groups, either to receive (test group) or not (control group) oral potassium supplementation in both Q4 2008 and the subsequent follow-up period, until 31 December 2014...
October 24, 2016: Renal Failure
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