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heart failure update

Irene Salamon, Gloria Saccani Jotti, Gianluigi Condorelli
PURPOSE OF REVIEW: In this review, we summarize new knowledge on long noncoding RNAs (lncRNAs) linked to cardiovascular disease, in particular to heart failure. RECENT FINDINGS: LncRNAs are dysregulated in specific developmental and pathological conditions and regulate critical responses to stress. LncRNAs are being recognized as molecules regulating myocardial remodeling during disease, participating for instance in the regulation of cardiomyocyte hypertrophy and function and fibroblast proliferation...
March 14, 2018: Current Opinion in Cardiology
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
Joshua A Beckman, Meredith S Duncan, Charles W Alcorn, Kaku So-Armah, Adeel A Butt, Matthew B Goetz, Hilary A Tindle, Jason Sico, Russel P Tracy, Amy C Justice, Matthew S Freiberg
Background -The effect of HIV on the development of peripheral artery disease (PAD) remains unclear. We investigated whether HIV infection is associated with an increased risk of PAD after adjustment for traditional atherosclerotic risk factors in a large cohort of HIV infected (HIV+) and demographically similar HIV uninfected veterans. Methods -We studied participants in the Veterans Aging Cohort Study from April 1, 2003 through December 31, 2014. We excluded participants with known prior PAD or prevalent cardiovascular disease (myocardial infarction, stroke, coronary heart disease, and congestive heart failure) and analyzed the effect of HIV status on the risk of incident PAD events after adjusting for demographics, PAD risk factors, substance use, CD4 cell count, HIV-1 RNA, and antiretroviral therapy...
March 13, 2018: Circulation
Wolfgang Miehsler, Clemens Dejaco, Hans-Peter Gröchenig, Harry Fuchssteiner, Christoph Högenauer, Lili Kazemi-Shirazi, Harald Maier, Andreas Mayer, Alexander Moschen, Walter Reinisch, Wolfgang Petritsch, Reingard Platzer, Pius Steiner, Herbert Tilg, Harald Vogelsang, Heimo Wenzl, Gottfried Novacek
Anti-TNFα-antibodies have revolutionized the therapy of inflammatory bowel diseases and other immune-mediated inflammatory diseases. Due to the increasing application of these substances, the Working Group of Inflammatory Bowel Diseases of the Austrian Association of Gastroenterology and Hepatology intended to update their consensus report on the safe use of Infliximab (published in 2010) and to enlarge its scope to cover all anti-TNFα-antibodies. The present consensus report summarizes the current evidence on the safe use of anti-TNFα-antibodies and covers the following topics: general risk of infection, bacterial infections (i...
March 2018: Zeitschrift Für Gastroenterologie
Amir Qaseem, Timothy J Wilt, Devan Kansagara, Carrie Horwitch, Michael J Barry, Mary Ann Forciea
Description: The American College of Physicians developed this guidance statement to guide clinicians in selecting targets for pharmacologic treatment of type 2 diabetes. Methods: The National Guideline Clearinghouse and the Guidelines International Network library were searched (May 2017) for national guidelines, published in English, that addressed hemoglobin A1c (HbA1c) targets for treating type 2 diabetes in nonpregnant outpatient adults. The authors identified guidelines from the National Institute for Health and Care Excellence and the Institute for Clinical Systems Improvement...
March 6, 2018: Annals of Internal Medicine
Robyn A Clark
BACKGROUND: In a series of studies over the past decade we have measured the effectiveness of telehealth for elderly heart failure patients (>70 years) on rehospitalisation, mortality, adherence, satisfaction, cost effectiveness, health related quality of life, age and types of technology. METHODS: Evidence has been derived from a Cochrane systematic review and meta-analysis (1 original and 2 updates: 2007-2016), two sub-analysis of this data and a large NHMRC funded multicentre randomised controlled trial (CHAT study 2010)...
2018: Studies in Health Technology and Informatics
Jessica Webb, Jane Draper, Tiago Rua, Yee Yiu, Susan Piper, Thomas Teall, Lauren Fovargue, Elena Bolca, Tom Jackson, Simon Claridge, Ben Sieniewicz, Bradley Porter, Adam McDiarmid, Ronak Rajani, Stamatis Kapetanakis, Christopher A Rinaldi, Reza Razavi, Theresa A McDonagh, Gerald Carr-White
AIMS: The 2014 National Institute of Clinical Excellence (NICE) guidelines on the management of acute heart failure recommended using a plasma NT-proBNP threshold of 300pg/ml to assist in ruling out the diagnosis of heart failure (HF), updating previous guidelines recommending using a threshold of 400pg/ml. NICE based their recommendations on 6 studies performed in other countries. This study sought to determine the diagnostic and economic implications of using these thresholds in a large unselected UK population...
April 15, 2018: International Journal of Cardiology
Nele Pattyn, Randy Beulque, Véronique Cornelissen
BACKGROUND: In a previous meta-analysis including nine trials comparing aerobic interval training with aerobic continuous training in patients with coronary artery disease, we found a significant difference in peak oxygen uptake favoring aerobic interval training. OBJECTIVE: The objective of this study was to (1) update the original meta-analysis focussing on peak oxygen uptake and (2) evaluate the effect on secondary outcomes. METHODS: We conducted a systematic review with a meta-analysis by searching PubMed and SPORTDiscus databases up to March 2017...
March 3, 2018: Sports Medicine
Charan Yerasi, Mohamad Lazkani, Prathik Kolluru, Varun Miryala, Jae Kim, Harsha Moole, Abhishek C Sawant, Michael Morris, Ashish Pershad
BACKGROUND: Left atrial appendage occlusion (LAAO) is a promising intervention for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Early outcomes following LAAO have been published in many studies with variable results. OBJECTIVE: This updated meta-analysis aims to provide a summary of the early outcomes of LAAO. METHODS: Medline/Pubmed, Ovid Journals, Clinical trials, Abstract meetings, Cochrane databases were searched from January 1st, 1999 to November 30th, 2016...
March 1, 2018: Journal of Interventional Cardiology
André Jacques Scheen
Dipeptidyl peptidase-4 inhibitors (DPP-4is) are generally considered as glucose-lowering agents with a safe profile in type 2 diabetes. Areas covered: An updated review of recent safety data from randomised controlled trials, observational studies, meta-analyses, pharmacovigilance reports regarding alogliptin, linagliptin, saxagliptin, sitagliptin, and vildagliptin, with a special focus on risks of hypoglycemia, pancreatitis and pancreatic cancer, major cardiovascular events, hospitalisation for heart failure and other new safety issues, such as bone fractures and arthralgia...
April 2018: Expert Opinion on Drug Safety
Jad Al Danaf, Javed Butler, Amin Yehya
PURPOSE OF REVIEW: Heart failure is a growing epidemic. Optimal medical therapy remains the cornerstone of heart failure management but device-based therapies have been shown to contribute to morbidity and mortality reduction. RECENT FINDINGS: Multiple investigational trials had been conducted in the past decade that helped us better understand and manage heart failure. In this manuscript, we will discuss the major device related trials of year 2017 in the fields of defibrillators, hemodynamic monitoring, remote monitoring, autonomic nervous system modulation, ventricular assist devices, and device-based valvular heart disease management...
February 17, 2018: Current Heart Failure Reports
Emmanouil Poulidakis, Constantina Aggeli, Konstantinos Kappos, Antonis S Manolis, Skevos Sideris, Konstantinos Gatzoulis, Evangelos Oikonomou, Dimitrios Tousoulis
Cardiac Resynchronization Therapy (CRT) is an established therapeutic option for the subset of patients with heart failure (HF), reduced ejection fraction (EF) and dyssynchrony evidenced by electrocardiography. Benefit from CRT has been proven in many clinical trials, yet a sizeable proportion of these patients with wide QRS do not respond to this intervention, despite the updated practice guidelines. Several echocardiographic indices, targeting mechanical rather than electrical dyssynchrony, have been suggested to address this issue, but research so far has not succeeded in providing a single and simple measurement with adequate sensitivity and specificity for identification of responders...
February 13, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Guanghong Jia, Michael A Hill, James R Sowers
Heart failure and related morbidity and mortality are increasing at an alarming rate, in large part, because of increases in aging, obesity, and diabetes mellitus. The clinical outcomes associated with heart failure are considerably worse for patients with diabetes mellitus than for those without diabetes mellitus. In people with diabetes mellitus, the presence of myocardial dysfunction in the absence of overt clinical coronary artery disease, valvular disease, and other conventional cardiovascular risk factors, such as hypertension and dyslipidemia, has led to the descriptive terminology, diabetic cardiomyopathy...
February 16, 2018: Circulation Research
Brian E Neubauer, Jeffery T Gray, Brian A Hemann
Heart failure represents a growing chronic medical condition with major implications on patient morbidity, mortality, and cost to health care systems. In this article, the heart failure syndrome is reviewed from a perspective of diagnosis and management, with updated therapeutic options reflected in major guidelines published since this topic was last reviewed in Primary Care Clinics in Office Practice in 2013. An emphasis is placed on the use of the American Heart Association/American College of Cardiology's staging system as a framework to improve early identification and treatment of patients at risk of symptomatic heart failure...
March 2018: Primary Care
Jessica Webb, Lauren Fovargue, Kristin Tøndel, Bradley Porter, Benjamin Sieniewicz, Justin Gould, Christopher Aldo Rinaldi, Tevfik Ismail, Amedeo Chiribiri, Gerald Carr-White
PURPOSE OF REVIEW: To give an update on the emerging role of cardiac magnetic resonance imaging in the evaluation of patients with heart failure with preserved ejection fraction (HFpEF). This is important as the diagnosis of HFpEF remains challenging and cardiac imaging is pivotal in establishing the function of the heart and whether there is evidence of structural heart disease or diastolic dysfunction. Echocardiography is widely available, although the gold standard in quantifying heart function is cardiac magnetic resonance (CMR) imaging...
February 5, 2018: Current Heart Failure Reports
N F Renna
An estimated 10% to 20% of hypertensive patients could be considered resistant to treatment (RH). These are patients who are not controlled using three drugs, at the maximum tolerated doses, including a diuretic, as well as those with high blood pressure controlled using four or more drugs. The term is used to identify patients that might benefit from special diagnostic and/or therapeutic consideration. The term 'refractory hypertension' has recently been proposed as a novel phenotype of antihypertensive failure...
January 31, 2018: Hipertensión y Riesgo Vascular
Salvatore De Rosa, Biagio Arcidiacono, Eusebio Chiefari, Antonio Brunetti, Ciro Indolfi, Daniela P Foti
Type 2 diabetes mellitus (DM) is a common metabolic disorder predisposing to diabetic cardiomyopathy and atherosclerotic cardiovascular disease (CVD), which could lead to heart failure through a variety of mechanisms, including myocardial infarction and chronic pressure overload. Pathogenetic mechanisms, mainly linked to hyperglycemia and chronic sustained hyperinsulinemia, include changes in metabolic profiles, intracellular signaling pathways, energy production, redox status, increased susceptibility to ischemia, and extracellular matrix remodeling...
2018: Frontiers in Endocrinology
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
Philipp Bahrmann, Roland Hardt
The incidence and prevalence of chronic heart failure (CHF) increase with age. In the second edition of the National Disease Management Guidelines (NVL) on CHF, published in August 2017, geriatric aspects are specifically addressed. The paper provides an overview of the recommendations by the guidelines on drug therapy, device therapy and operative therapy as well on the coordination of care focusing on older and multimorbid patients.
February 2018: Zeitschrift Für Gerontologie und Geriatrie
Rebecca S Crow, Matthew C Lohman, Alexander J Titus, Martha L Bruce, Todd A Mackenzie, Stephen J Bartels, John A Batsis
OBJECTIVES: To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN: Longitudinal mortality analysis. SETTING: National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS: Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% female). MEASUREMENTS: We used data from 1999-2004 cross-sectional NHANES and mortality data from the National Death Index, updated through December 2011...
January 25, 2018: Journal of the American Geriatrics Society
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