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https://www.readbyqxmd.com/read/29161389/innovations-in-management-of-cardiac-disease-drugs-treatment-strategies-and-technology
#1
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159789/heart-failure-and-kidney-disease
#2
Dario Grande, Margherita Ilaria Gioia, Paola Terlizzese, Massimo Iacoviello
Kidney disease is commonly found in heart failure (HF) patients. They share many risk factors and common pathophysiological pathways which often lead to mutual dysfunction. Both haemodynamic and non-haemodynamic mechanisms are involved in the development of renal impairment in heart failure patients. Moreover, the presence of a chronic kidney disease is a significant independent predictor of worse outcome in chronic as well as in acute decompensated HF. As a consequence, an accurate evaluation of renal function plays a key role in the management of HF patients...
November 21, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29159270/the-circular-rna-micra-for-risk-stratification-after-myocardial-infarction
#3
Antonio Salgado-Somoza, Lu Zhang, Melanie Vausort, Yvan Devaux
Background: A significant proportion of patients develop heart failure (HF) after acute myocardial infarction (MI). Predicting this development with novel biomarkers would allow tailoring healthcare to each individual. We recently identified a circular RNA called MICRA which was associated with HF development after MI. Here, we tested whether MICRA was able to risk stratify MI patients. Methods: MICRA was assessed in whole blood samples collected at reperfusion in 472 patients with acute MI...
December 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29158065/electrocardiographic-predictors-of-morbidity-and-mortality-in-patients-with-acute-myocarditis-the-importance-of-qrs-t-angle
#4
Shmuel Chen, Sarah Hoss, Vicki Zeniou, Ayelet Shauer, Dan Admon, Donna R Zwas, Chaim Lotan, Andre Keren, Israel Gotsman
BACKGROUND: Acute myocarditis carries a variable prognosis. We evaluated the morbidity and mortality rates in patients with acute myocarditis and admission electrocardiographic predictors of outcome. METHODS: Patients admitted to a tertiary hospital with a clinical diagnosis of acute myocarditis were evaluated. RESULTS: 193 patients were included. Median follow-up was 5.7 years; 82% were males, median age of 30 years (21-39). The most common clinical presentations were chest pain (77%) and fever (53%)...
November 17, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29158060/meta-analysis-of-the-outcome-after-postcardiotomy-venoarterial-extracorporeal-membrane-oxygenation-in-adult-patients
#5
Fausto Biancari, Andrea Perrotti, Magnus Dalén, Mariapia Guerrieri, Antonio Fiore, Daniel Reichart, Angelo M Dell'Aquila, Giuseppe Gatti, Tero Ala-Kokko, Eeva-Maija Kinnunen, Tuomas Tauriainen, Sidney Chocron, Juhani K E Airaksinen, Vito G Ruggieri, Debora Brascia
OBJECTIVE: This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. DESIGN: Systematic review of the literature and meta-analysis. SETTING: Multi-institutional study. PARTICIPANTS: Adult patients with acute heart failure immediately after cardiac surgery. INTERVENTIONS: VA-ECMO after cardiac surgery...
September 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29158054/early-outcomes-for-valve-in-valve-tavr-in-degenerative-freestyle-bioprostheses
#6
Stephane Leung Wai Sang, Tyler Beute, John Heiser, Duane Berkompas, Justin Fanning, William Merhi
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) is used increasingly to treat bioprosthetic valve failure. A paucity of data exists regarding valve-in-valve (ViV) TAVR in degenerated Freestyle stentless bioprostheses (FSB). This study sought to evaluate the feasibility and short-term outcomes of ViV TAVR in previously placed FSB. METHODS: From October 2014 to September 2016, 22 patients underwent ViV TAVR with a self-expanding transcatheter valve for a failing FSB at a single institution...
November 17, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29158023/statin-has-more-protective-effects-in-ami-patients-with-higher-plasma-bnp-or-nt-probnp-level-but-not-with-lower-left-ventricular-ejection-fraction
#7
Jaelim Cho, Ie Byung Park, Kiyoung Lee, Tae Hoon Ahn, Won Bin Park, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Dae Ho Lee
BACKGROUND: The benefit of statin therapy in patients with higher grades of heart failure has yet to be determined. The present study investigated whether statin therapy affects major composite outcomes (MCOs) and all-cause mortality in patients with acute myocardial infarction (AMI) within 1 year after AMI, according to their plasma natriuretic peptide (NP) levels and left ventricular ejection fraction (LVEF). METHODS: A total of 11,492 patients with AMI from two nationwide registry databases in Korea were analyzed...
November 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29157297/smoldering-myocarditis-following-immune-checkpoint-blockade
#8
Timothy G Norwood, Brian C Westbrook, Douglas B Johnson, Silvio H Litovsky, Nina L Terry, Svetlana B McKee, Alan S Gertler, Javid J Moslehi, Robert M Conry
BACKGROUND: Severe myocarditis associated with electrical conduction abnormalities and occasionally heart failure has been well documented following treatment with immune checkpoint blockade with an estimated incidence of less than 1%. However, the incidence, early detection, and management of less severe immune-related myocarditis are unknown since most immunotherapy trials have not included routine cardiac monitoring. Herein, we provide the first description of subclinical or smoldering myocarditis with minimal signs and symptoms following immune checkpoint blockade with a single dose of ipilimumab and nivolumab...
November 21, 2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/29154687/pyruvate-enhancement-of-cardiac-performance-cellular-mechanisms-and-clinical-application
#9
Robert T Mallet, Albert H Olivencia-Yurvati, Rolf Bünger
Cardiac contractile function is adenosine-5'-triphosphate (ATP)-intensive, and the myocardium's high demand for oxygen and energy substrates leaves it acutely vulnerable to interruptions in its blood supply. The myriad cardioprotective properties of the natural intermediary metabolite pyruvate make it a potentially powerful intervention against the complex injury cascade ignited by myocardial ischemia-reperfusion. A readily oxidized metabolic substrate, pyruvate augments myocardial free energy of ATP hydrolysis to a greater extent than the physiological fuels glucose, lactate and fatty acids, particularly when it is provided at supra-physiological plasma concentrations...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29154421/haemodynamic-monitoring-of-cardiac-status-using-heart-sounds-from-an-implanted-cardiac-device
#10
Pramodsingh H Thakur, Qi An, Lynne Swanson, Yi Zhang, Roy S Gardner
AIM: The aim of this study was to evaluate the haemodynamic correlates of heart sound (HS) parameters such as third HS (S3), first HS (S1), and HS-based systolic time intervals (HSTIs) from an implantable cardiac device. METHODS AND RESULTS: Two unique animal models (10 swine with myocardial ischaemia and 11 canines with pulmonary oedema) were used to evaluate haemodynamic correlates of S1, S3, and HSTIs, namely, HS-based pre-ejection period (HSPEP), HS-based ejection time (HSET), and the ratio HSPEP/HSET during acute haemodynamic perturbations...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154419/clinical-profiles-and-prognosis-of-acute-heart-failure-in-adult-patients-with-dystrophinopathies-on-home-mechanical-ventilation
#11
Abdallah Fayssoil, Rabah Ben Yaou, Adam Ogna, France Leturcq, Olivier Nardi, Bernard Clair, Karim Wahbi, Frederic Lofaso, Pascal Laforet, Denis Duboc, David Orlikowski, Djillali Annane
AIMS: Duchenne muscular dystrophy (DMD) is characterized by respiratory and heart involvements. In the context of permanently wheelchair bound and on mechanical ventilation (MV) patients, the clinical presentation of acute heart failure (AHF) syndrome may be atypical. We sought to describe clinical and genetic profiles and to determine prognosis of DMD and Becker muscular dystrophy (BMD) patients on home MV (HMV), hospitalized for AHF. METHODS AND RESULTS: We included genetically proven DMD and BMD patients on HMV admitted for AHF...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154417/impact-of-chronic-kidney-disease-on-the-diuretic-response-of-tolvaptan-in-acute-decompensated-heart-failure
#12
Shuntaro Ikeda, Kiyotaka Ohshima, Shigehiro Miyazaki, Hisaki Kadota, Hideaki Shimizu, Akiyoshi Ogimoto, Mareomi Hamada
AIM: This study investigated the relationship between the initial diuretic response to tolvaptan and clinical predictors for tolvaptan responders in patients with acute decompensated heart failure (ADHF). METHODS AND RESULTS: Patients (153) with ADHF (clinical scenario 2 or 3 with signs of fluid retention) who were administered tolvaptan were enrolled. Tolvaptan (15 or 7.5 mg) was administered for at least 7 days to those patients in whom fluid retention was observed even after standard treatment...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154416/left-ventricular-global-longitudinal-strain-in-patients-with-heart-failure-with-preserved-ejection-fraction-outcomes-following-an-acute-heart-failure-hospitalization
#13
Jonathan Buggey, Fawaz Alenezi, Hyun Ju Yoon, Matthew Phelan, Adam D DeVore, Michel G Khouri, Phillip J Schulte, Eric J Velazquez
AIMS: While abnormal resting LV GLS has been described in patients with chronic heart failure with preserved ejection fraction (HFpEF), its prognostic significance when measured during an acute heart failure hospitalization remains unclear. We assessed the association between left ventricular global longitudinal strain (LV GLS) and outcomes in patients hospitalized with acute HFpEF. METHODS AND RESULTS: We studied patients discharged alive for acute HFpEF from Duke University Medical Center between 2007 and 2010...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154415/persistent-high-blood-urea-nitrogen-level-is-associated-with-increased-risk-of-cardiovascular-events-in-patients-with-acute-heart-failure
#14
Kentaro Jujo, Yuichiro Minami, Shintaro Haruki, Yuya Matsue, Kensuke Shimazaki, Hiromu Kadowaki, Issei Ishida, Keigo Kambayashi, Hiroyuki Arashi, Haruki Sekiguchi, Nobuhisa Hagiwara
AIMS: The association between kinetics of blood urea nitrogen (BUN) levels in hospital and cardiovascular outcomes in patients with acutely decompensated congestive heart failure (HF) is unclear. We aimed to estimate the impact of changes in BUN level during hospitalization on clinical prognosis in patients with acute HF. METHODS AND RESULTS: A total of 353 consecutive patients that were urgently hospitalized due to acutely decompensated HF and discharged alive were divided into four subgroups depending on their BUN level at admission and discharge, using a cut-off level of 21...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153757/-pulmonary-tumor-thrombotic-microangiopathy
#15
REVIEW
M Merad, A Alibay, S Ammari, S Antoun, A Bouguerba, S Ayed, F Vincent
Pulmonary tumor thrombotic microangiopathy syndrome is a rare clinicopathological entity in which tumor cell micro-emboli in the pulmonary microcirculation induced thrombotic microangiopathy. This can cause respiratory failure, and acute or sub-acute right heart failure. Histological features include micro tumor emboli in the small arteries and arterioles of the lung associated with thrombus formation and fibro-cellular and fibro-muscular intimal proliferation. The diagnosis is however extremely difficult to make before death...
November 16, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29153575/persistent-iron-within-the-infarct-core%C3%A2-after-st-segment-elevation-myocardial-infarction-implications-for-left-ventricular-remodeling-and-health%C3%A2-outcomes
#16
Jaclyn Carberry, David Carrick, Caroline Haig, Nadeem Ahmed, Ify Mordi, Margaret McEntegart, Mark C Petrie, Hany Eteiba, Stuart Hood, Stuart Watkins, Mitchell Lindsay, Andrew Davie, Ahmed Mahrous, Ian Ford, Naveed Sattar, Paul Welsh, Aleksandra Radjenovic, Keith G Oldroyd, Colin Berry
OBJECTIVES: This study sought to determine the incidence and prognostic significance of persistent iron in patients post-ST-segment elevation myocardial infarction (STEMI). BACKGROUND: The clinical significance of persistent iron within the infarct core after STEMI complicated by acute myocardial hemorrhage is poorly understood. METHODS: Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI [Detection and Significance of Heart Injury in ST Elevation Myocardial Infarction])...
November 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29153211/-heart-failure-progress-and-challenges
#17
Thibaud Damy
Heart failure is a pathology which is constantly growing due to the ageing population. It is defined as the heart's inability to pump enough blood to meet the body's metabolic and nutritional needs. Treatment varies depending on the acute or chronic phases. The care pathway is sometimes complex. Monitoring and patient education are essential.
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29153201/troponin-in-heart-failure
#18
REVIEW
Kevin S Shah, Alan S Maisel, Gregg C Fonarow
Cardiac troponin is an integral biomarker in the evaluation and management of patients with acute coronary syndrome. Troponin is also established as a valuable prognostic marker in patients with acute or chronic heart failure (HF). As the sensitivity of troponin assays transition to high sensitive troponin, more patients with HF will have detectable troponin. In this review, the authors discuss the current literature on the value of troponin in the management of patients with HF. Furthermore, the authors highlight the potential for future strategies to use troponin as a potential target for therapy in patients with HF...
January 2018: Heart Failure Clinics
https://www.readbyqxmd.com/read/29153199/soluble-st2-in-heart-failure
#19
REVIEW
Cian P McCarthy, James L Januzzi
Suppression of tumorigenicity 2 (ST2) is a member of the interleukin (IL)-1 receptor family, whose role was originally established in the context of inflammatory and autoimmune diseases. More recently, testing for ST2 has been used in the setting of cardiovascular disease. The soluble form of ST2 is a decoy receptor that inhibits beneficial cardioprotective effects of IL-33; such inhibition results in cardiac hypertrophy, myocardial fibrosis, and ventricular dysfunction. Measurement of soluble ST2 has utility for assessing heart failure severity and prognosis...
January 2018: Heart Failure Clinics
https://www.readbyqxmd.com/read/29153198/n-terminal-b-type-natriuretic-peptide-in-heart-failure
#20
REVIEW
Arthur Mark Richards
Plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) is a guideline-mandated biomarker in heart failure (HF). Used as an inclusion criterion for therapeutic trials, NT-proBNP enriches trial populations and is a valid surrogate endpoint. Its diagnostic performance is best validated in acute decompensated HF (ADHF). NT-proBNP offers prognostic information independent of standard clinical predictors and refines risk stratification. With the advent of combined angiotensin 2 type 1 receptor blockade and neprilysin inhibition (ARNI) NT-proBNP retains its relationship to cardiac status and is the marker of choice in assessment of possible ADHF and in serial monitoring of HF patients receiving ARNI treatment...
January 2018: Heart Failure Clinics
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