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Treatment of heart failure

Qian Wang, Lu Liu, Ling Gao, Qiu Li
AIM: To show long-term cardiovascular safety of the GLP-1 receptor agonists for diabetes patients with cardiovascular risk. METHODS: For cardiovascular outcomes, the association between treatment and outcomes was estimated using the odds ratio and 95% confidence interval. I2 test was adopted to assess the magnitude of heterogeneity between studies, with values more than 25%, 50%, and 75% defined as low, moderate, or high heterogeneity. RESULTS: We combined data from four cardiovascular outcomes trials and prospectively blinded endpoint adjudication...
June 20, 2018: Diabetes Research and Clinical Practice
Daniala L Weir, Michal Abrahamowicz, Marie-Eve Beauchamp, Dean T Eurich
AIMS: Observational studies evaluating the safety and effectiveness of metformin have yielded ambiguous results, possibly due to how time-varying drug exposure was modeled. Therefore, our objective was to re-evaluate the association between metformin use and heart failure (HF) exacerbation in patients with type 2 diabetes (T2D) and pre-existing HF using alternative exposure models. MATERIALS AND METHODS: We analyzed data for patients with T2D and incident HF from a national U...
June 23, 2018: Diabetes, Obesity & Metabolism
Per Wändell, Axel C Carlsson, Jan Sundquist, Kristina Sundquist
Risk of dementia is increased in patients with atrial fibrillation (AF). We aimed to study associations between relevant comorbidities and prevalent as well as incident dementia in AF patients. Study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centers in Sweden 2001-2007. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (95% CI) for associations between comorbidities and prevalent dementia. In a subsample (n = 12,096), (excluding patients with dementia diagnosed before AF onset), Cox regression was used to estimate hazard ratios (HR) with 95% CIs for association between comorbidities, and incident dementia, after adjustment for age, socioeconomic factors and anticoagulant treatment...
June 22, 2018: GeroScience
Naoto Tominaga, Keisuke Kida, Takayuki Inomata, Naoki Sato, Tohru Izumi, Yoshihiro J Akashi, Yugo Shibagaki
BACKGROUND: Tolvaptan (TLV) is known to increase electrolyte-free water clearance. However, TLV actions on renal electrolytes including urine sodium (uNa) excretion and its consequences are less well understood. This subanalysis investigated the effect of add-on TLV compared to increased furosemide (FUR) on both electrolyte-free water and electrolyte clearance in patients with congestive heart failure (CHF) complicated by advanced chronic kidney disease (CKD). METHODS: The Kanagawa Aquaresis Investigators Trial of TLV on HF Patients with Renal Impairment (K-STAR) was a multicenter, open-labeled, randomized, and controlled prospective clinical study...
June 22, 2018: Clinical and Experimental Nephrology
Tetsuro Tsujimoto, Hiroshi Kajio
To assess whether beta-blocker use is associated with cardiovascular events and mortality in patients with heart failure with preserved ejection fraction (HFpEF), this study analyzed the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial data using Cox proportional hazard models. Adjusted HRs for composite cardiovascular events in all patients and in patients without previous MI were significantly higher for those on beta-blockers than for those not on beta-blockers (Hazard ratio [HR] for all patients 1...
June 22, 2018: Scientific Reports
Lawrence H Young, Catherine M Viscoli, Gregory G Schwartz, Silvio E Inzucchi, Jeptha P Curtis, Mark J Gorman, Karen L Furie, Robin Conwit, Erica Spatz, Anne Lovejoy, J Dawn Abbott, Daniel L Jacoby, Daniel M Kolansky, Frederick S Ling, Steven E Pfau, Walter N Kernan
Background -The Insulin Resistance Intervention after Stroke (IRIS) trial demonstrated that pioglitazone reduced risk for both cardiovascular events and diabetes in insulin resistant patients. However, concern remains that pioglitazone may increase risk for heart failure (HF) in susceptible individuals. Methods -In IRIS, patients with insulin resistance but without diabetes were randomized to pioglitazone or placebo (1:1) within 180 days of an ischemic stroke or TIA and followed for up to 5 years. To identify patients at higher HF risk with pioglitazone we performed a secondary analysis of IRIS participants without HF history at entry...
June 22, 2018: Circulation
Nirmal Parajuli, Shingo Takahara, Nobutoshi Matsumura, Ty T Kim, Mourad Ferdaoussi, Anna K Migglautsch, Rudolf Zechner, Rolf Breinbauer, Erin E Kershaw, Jason R B Dyck
RATIONALE: Despite the advancement in therapies for cardiovascular disease and heart failure (HF), the incidence and prevalence of HF is increasing. Previous work has suggested that inhibiting adipose triglyceride lipase (ATGL) in adipose tissue during HF development may assist in the treatment of HF. The ability to specifically target the adipocyte as a potential treatment for HF is a novel approach that could significantly influence the management of HF in the future. OBJECTIVES: To assess the cardiac structural and functional effects of pharmacological inhibition of ATGL in mice with HF, to assess if ATGL inhibition works in an adipocyte autonomous manner, and to determine the role that adiposity and glucose homeostasis play in this HF treatment approach...
June 22, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Toshikazu D Tanaka, Mitsuaki Sawano, Ravi Ramani, Mark Friedman, Shun Kohsaka
Globally, acute heart failure (AHF) remains an ongoing public health issue with its prevalence and mortality increasing in the east and the west. Effective treatment strategies to stabilize AHF are important to alleviate clinical symptoms and to improve clinical outcomes. However, despite the progress in the management of stable and chronic heart failure, no single agent has been proven to play a definitive role in the management of AHF. As a consequence, contemporary treatment strategies for patients with AHF vary greatly by region...
June 22, 2018: ESC Heart Failure
Anne-Catherine Pouleur, Stefan Anker, Dulce Brito, Oana Brosteanu, Dirk Hasenclever, Barbara Casadei, Frank Edelmann, Gerasimos Filippatos, Damien Gruson, Ignatios Ikonomidis, Renaud Lhommel, Masliza Mahmod, Stefan Neubauer, Alexandre Persu, Bernhard L Gerber, Stefan Piechnik, Burkert Pieske, Elisabeth Pieske-Kraigher, Fausto Pinto, Piotr Ponikowski, Michele Senni, Jean-Noël Trochu, Nancy Van Overstraeten, Rolf Wachter, Jean-Luc Balligand
AIMS: Progressive left ventricular (LV) remodelling with cardiac myocyte hypertrophy, myocardial fibrosis, and endothelial dysfunction plays a key role in the onset and progression of heart failure with preserved ejection fraction. The Beta3-LVH trial will test the hypothesis that the β3 adrenergic receptor agonist mirabegron will improve LV hypertrophy and diastolic function in patients with hypertensive structural heart disease at high risk for developing heart failure with preserved ejection fraction...
June 22, 2018: ESC Heart Failure
Anubhav Bussooa, Steven Neale, John R Mercer
Cardiovascular disease remains the leading cause of death in Western society. Recent technological advances have opened the opportunity of developing new and innovative smart stent devices that have advanced electrical properties that can improve diagnosis and even treatment of previously intractable conditions, such as central line access failure, atherosclerosis and reporting on vascular grafts for renal dialysis. Here we review the latest advances in the field of cardiovascular medical implants, providing a broad overview of the application of their use in the context of cardiovascular disease rather than an in-depth analysis of the current state of the art...
June 22, 2018: Sensors
Neha Quatromoni, Marielle Scherrer-Crosbie
PURPOSE OF REVIEW: Modern cancer therapy comes at a cost of increased risk of cardiotoxicity. The purpose of our paper is to provide an updated review highlighting research incorporating biomarkers and imaging findings for the detection of subclinical cardiac dysfunction and management of cancer treatment-related cardiotoxicity. RECENT FINDINGS: Biomarkers, particularly troponin, NTproBNP, and myeloperoxidase, have been shown to have a predictive role in the development of cancer treatment-related cardiotoxicity...
June 22, 2018: Current Cardiology Reports
Andrea Grund, Malgorzata Szaroszyk, Janina K Döppner, Mona Malek Mohammadi, Badder Kattih, Mortimer Korf-Klingebiel, Anna Gigina, Michaela Scherr, George Kensah, Monica Jara-Avaca, Ina Gruh, Ulrich Martin, Kai C Wollert, Antje Gohla, Hugo A Katus, Oliver J Müller, Johann Bauersachs, Joerg Heineke
Aims: Chronic heart failure is becoming increasingly prevalent and is still associated with a high mortality rate. Myocardial hypertrophy and fibrosis drive cardiac remodeling and heart failure, but they are not sufficiently inhibited by current treatment strategies. Furthermore, despite increasing knowledge on cardiomyocyte intracellular signaling proteins inducing pathological hypertrophy, therapeutic approaches to target these molecules are currently unavailable. In this study, we aimed to establish and test a therapeutic tool to counteract the 22kDa calcium and integrin binding protein (CIB) 1, which we have previously identified as nodal regulator of pathological cardiac hypertrophy and as activator of the maladaptive calcineurin/NFAT axis...
June 20, 2018: Cardiovascular Research
Russell B Hawkins, Kristina Go, Steven L Raymond, Alexander Ayzengart, Jeffrey Friedman
BACKGROUND: Obesity is an epidemic that is closely associated with heart failure. The ultimate treatment for end-stage heart failure is cardiac transplantation. Patients with morbid obesity are often excluded from receiving donor organs. Many transplant centers use body mass index (BMI) >35 kg/m2 as a contraindication to listing for heart transplant. Left ventricular assist devices (LVADs) were developed as a bridge to transplant for many heart failure patients, but bariatric surgery for LVAD patients has not been well described...
April 19, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Anders Ulvenstam, Robin Henriksson, Lars Söderström, Thomas Mooe
Aims It is unknown whether dual antiplatelet therapy with ticagrelor instead of clopidogrel reduces the risk of ischaemic stroke in acute myocardial infarction patients that undergo percutaneous coronary intervention. This study investigated whether the introduction of dual antiplatelet therapy with ticagrelor was associated with reduced ischaemic stroke risk in a real-world population. Methods and results Patients with ischaemic stroke after acute myocardial infarction from 8 December 2009-31 December 2013 were identified using the Register for Information and Knowledge on Swedish Heart Intensive Care Admissions and the Swedish National Patient Register...
January 1, 2018: European Journal of Preventive Cardiology
Marina Navarro-Peñalver, M Teresa Perez-Martinez, Manuel Gómez-Bueno, Pablo García-Pavía, Josep Lupón-Rosés, Eulalia Roig-Minguell, Josep Comin-Colet, Antoni Bayes-Genis, Jose A Noguera, Domingo A Pascual-Figal
BACKGROUND: Testosterone deficiency is associated with heart failure (HF) progression and poor prognosis. Testosterone therapy has been shown to improve exercise capacity in patients with chronic HF, but no trial has evaluated the impact of replacement in patients with demonstrated testosterone deficiency. METHODS: Prospective, randomized, double-blind, placebo-controlled, and parallel-group trial comparing testosterone replacement with placebo in males with chronic HF with reduced ejection fraction (HFrEF) and testosterone deficiency (NCT01813201)...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
Douglas A Simonetto, Hala Fatima, Folkert Zijlstra, Michael K Zijlstra
Ascites is an abnormal accumulation of fluid within the peritoneal cavity. The most common cause of ascites in the United States population is portal hypertension secondary to cirrhosis, accounting for about 80% of the cases. Other etiologies include malignancy, heart failure, tuberculosis, and pancreatic disease. After an extensive literature review, it is to our best knowledge that there have been no cases reported on autoimmune ascites. We present an interesting case of ascites in a 67-year-old Caucasian male with symptoms of recurrent abdominal distention and significant weight gain, refractory to standard therapies...
May 2018: Case Reports in Gastroenterology
Gabrielius Jakutis, Vytautas Juknevičius, Juratė Barysienė, Dalia Matačiūnienė, Birutė Petrauskienė, Žaneta Petrulionienė, Aleksandras Laucevičius
Introduction: Rapid eye movement (REM) sleep-related bradyarrhythmia syndrome is characterized by pathological asystoles during the REM sleep phase. It is a rare rhythm disorder, being reported only few times in the literature. Due to non-specific symptoms, REM sleep-related bradyarrhythmia might be often underdiagnosed. Other cardiac diseases associated with pathological sinus arrests must be excluded to establish the correct diagnosis of and appropriate therapy for REM sleep-related bradyarrhythmia...
2018: Acta Medica Lituanica
Jianjun Yu, Wei Li, Dongmei Yu
Purpose: Myocardial infarction is a major cause of mortality and heart failure worldwide. One of the most effective methods of this injury is direct delivery of cardioprotective drugs to ischemia-reperfusion (IR) myocardium. The aim of the present study was to fabricate an adenosine (Ade) prodrug-based, atrial natriuretic peptide (ANP)-modified nanosystem for the treatment of myocardial infarction. Materials and methods: Oleate adenosine prodrug (Ade-OA) and ANP-distearoylphosphatidylethanolamine-polyethylene glycol were synthesized...
2018: Drug Design, Development and Therapy
Che-Sheng Chu, Wan-Rung Li, Kuan-Lun Huang, Pei-Yu Su, Ching-Heng Lin, Tsuo-Hung Lan
OBJECTIVE: The purpose of this study was to identify the association between antipsychotics and mortality in Alzheimer's disease patients. METHODS: Using the Taiwan National Health Insurance Research Database, 735 newly diagnosed Alzheimer's disease patients aged over 65 years and receiving antipsychotic treatments, and 735 age, sex, physical comorbidity, and entry year with propensity scores, matched control subjects were enrolled and followed for a 10-year period until the end of 2011...
June 1, 2018: Journal of Psychopharmacology
A Ancion, S Robinet, P Lancellotti
Cardiac tamponade is a vital emergency. It occurs when the accumulation of intra-pericardial fluid exceeds the pericardial adaptation capacity. Pericardial pressure is equalized with that of cardiac cavities and severe heart failure occurs, most often rapidly. Several clinical presentations are possible. The diagnosis is based on the assessment of pericardial effusion and its impact on the heart by echocardiography. Supportive treatments have limited effectiveness. The only emergency treatment is drainage of the pericardium by direct puncture or by surgical approach...
May 2018: Revue Médicale de Liège
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