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Chronic Heart failure treatment

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https://www.readbyqxmd.com/read/29782282/-cell-therapy-of-chronic-heart-failure-state-of-the-art
#1
S A Beliy, V V Komok
The treatment of patients with CHF using autologous bone marrow-derived mononuclear cell fraction (or its derivatives) is a promising therapy for this serious and numerous group of patients. The article analyzed international and Russian experience of using the cell therapy in patients with CHF and possibilities for extensive use of the autologous bone marrow-derived mononuclear cell fraction in clinical practice.
2018: Kardiologiia
https://www.readbyqxmd.com/read/29781322/the-impact-of-chronic-kidney-disease-on-medication-choice-and-pharmacologic-management-in-patients-with-heart-failure
#2
Syed Raza Shah, David E Winchester
In the past few years, medical community, including doctors, have become increasingly aware of the fact that chronic kidney disease (CK) and heart failure (HF) have common risk factors which impacts one another in terms of choice of therapy. Areas covered: Management of these two diseases has been a challenge for physicians. The treatment goals for HF patients in CK are very important. They serve as the end-point in using a specific treatment for management and treatment of CK patients hence, decreasing mortality rates...
May 21, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29780030/effect-of-multimorbidity-on-survival-of-patients-diagnosed-with-heart-failure-a-retrospective-cohort-study-in-singapore
#3
Palvinder Kaur, Nakul Saxena, Alex Xiaobin You, Raymond C C Wong, Choon Pin Lim, Seet Yoong Loh, Pradeep Paul George
OBJECTIVE: Multimorbidity in patients with heart failure (HF) results in poor prognosis and is an increasing public health concern. We aim to examine the effect of multimorbidity focusing on type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) on all-cause and cardiovascular disease (CVD)-specific mortality among patients diagnosed with HF in Singapore. DESIGN: Retrospective cohort study. SETTING: Primary and tertiary care in three (out of six) Regional Health Systems in Singapore...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#4
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29774407/beta-blockers-and-chronic-heart-failure-patients-prognostic-impact-of-a-dose-targeted-beta-blocker-therapy-vs-heart-rate-targeted-strategy
#5
Anna Corletto, Hanna Fröhlich, Tobias Täger, Matthias Hochadel, Ralf Zahn, Caroline Kilkowski, Ralph Winkler, Jochen Senges, Hugo A Katus, Lutz Frankenstein
BACKGROUND: Beta blockers improve survival in patients with chronic systolic heart failure (CHF). Whether physicians should aim for target dose, target heart rate (HR), or both is still under debate. METHODS AND RESULTS: We identified 1,669 patients with systolic CHF due to ischemic heart disease or idiopathic dilated cardiomyopathy from the University Hospital Heidelberg and the Clinic of Ludwigshafen, Germany. All patients were treated with an angiotensin converting enzyme inhibitor or angiotensin receptor blocker and had a history of CHF known for at least 6 months...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29773163/epicardial-adipose-tissue-may-mediate-deleterious-effects-of-obesity-and-inflammation-on-the-myocardium
#6
REVIEW
Milton Packer
Epicardial adipose tissue has unique properties that distinguish it from other depots of visceral fat. Rather than having distinct boundaries, the epicardium shares an unobstructed microcirculation with the underlying myocardium, and in healthy conditions, produces cytokines that nourish the heart. However, in chronic inflammatory disorders (especially those leading to heart failure with preserved ejection fraction), the epicardium becomes a site of deranged adipogenesis, leading to the secretion of proinflammatory adipokines that can cause atrial and ventricular fibrosis...
May 22, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29770365/is-the-epicardial-left-ventricular-lead-implantation-an-alternative-approach-to-percutaneous-attempt-in-patients-with-steinert-disease-a-case-report
#7
Andrea Antonio Papa, Anna Rago, Roberta Petillo, Paola D'Ambrosio, Marianna Scutifero, Marisa DE Feo, Ciro Maiello, Alberto Palladino
Steinert's disease or Myotonic Dystrophy type 1 (DM1) is an autosomal dominant multisystemic disorder characterized by myotonia, muscle and facial weakness, cataracts, cognitive, endocrine and gastrointestinal involvement, and cardiac conduction abnormalities. Although mild myocardial dysfunction may be detected in this syndrome with age, overt myocardial dysfunction with heart failure is not frequent. Cardiac resynchronization therapy is an effective treatment to improve morbidity and reduce mortality in patients with DM1 showing intra-ventricular conduction delay and/or congestive heart failure...
December 2017: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
https://www.readbyqxmd.com/read/29767459/long-term-effects-of-patiromer-for-hyperkalaemia-treatment-in-patients-with-mild-heart-failure-and-diabetic-nephropathy-on-angiotensin-converting-enzymes-angiotensin-receptor-blockers-results-from-amethyst-dn
#8
Bertram Pitt, George L Bakris, Matthew R Weir, Mason W Freeman, Mitja Lainscak, Martha R Mayo, Dahlia Garza, Rezi Zawadzki, Lance Berman, David A Bushinsky
AIMS: Chronic kidney disease (CKD) in heart failure (HF) increases the risk of hyperkalaemia (HK), limiting angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use. Patiromer is a sodium-free, non-absorbed potassium binder approved for HK treatment. We retrospectively evaluated patiromer's long-term safety and efficacy in HF patients from AMETHYST-DN. METHODS AND RESULTS: Patients with Type 2 diabetes, CKD, and HK [baseline serum potassium >5...
May 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29762337/real-life-indications-to-ivabradine-treatment-for-heart-rate-optimization-in-patients-with-chronic-systolic-heart-failure
#9
Lara Tondi, Gabriele Fragasso, Roberto Spoladore, Giuseppe Pinto, Marco Gemma, Massimo Slavich, Cosmo Godino, Anna Salerno, Claudia Montanaro, Alberto Margonato
: Ivabradine is a selective and specific inhibitor of If current. With its pure negative chronotropic action, it is recommended by European Society of Cardiology and American College of Cardiology/American Heart Association guidelines in symptomatic heart failure patients (NYHA ≥ 2) with ejection fraction 35% or less, sinus rhythm and heart rate (HR) at least 70 bpm, despite maximally titrated β-blocker therapy. Data supporting this indication mainly derive from the SHIFT study, in which ivabradine reduced the combined endpoint of mortality and hospitalization, despite the fact that only 26% of patients enrolled were on optimal β-blocker doses...
May 11, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29760016/diabetes-induced-cardiomyocyte-passive-stiffening-is-caused-by-impaired-insulin-dependent-titin-modification-and-can-be-modulated-by-neuregulin-1
#10
Anna-Eliane Hopf, Christian Andresen, Sebastian Kötter, Malgorzata Isic, Kamila Ulrich, Senem Sahin, Sabine Bongardt, Wilhelm Roell, Felicitas Drove, Nina Scheerer, Leni Vandekerckhove, Gilles W De Keulenaer, Nazha Hamdani, Wolfgang A Linke, Martina Krüger
<u>Rationale:</u> Increased titin-dependent cardiomyocyte tension is a hallmark of heart failure with preserved ejection fraction (HFpEF) associated with type-2 diabetes mellitus (T2DM). However, the insulin-related signaling pathways that modify titin-based cardiomyocyte tension, thereby contributing to modulation of diastolic function, are largely unknown. <u>Objective:</u> We aimed to determine how impaired insulin signaling affects titin expression and phosphorylation and thus increases passive cardiomyocyte tension, and whether metformin or neuregulin-1 can correct disturbed titin modifications and increased titin-based stiffness...
May 14, 2018: Circulation Research
https://www.readbyqxmd.com/read/29755837/chagasic-cardiomyopathy-and-pompe-disease-case-report
#11
Rafael Ob de Morais, Ândrea V Chaves-Markman, Anna Pp Miranda, Ingrid G Amorim, Maria da Ga de M Cavalcanti, Manuel Markman, Brivaldo Markman-Filho
BACKGROUND: Pompe disease is a lysosomal storage disease with an autosomal recessive inheritance characterized by an insufficient activity of the acid alpha-glucosidase enzyme. The incidence varies from 1:40000 to 1:200000 live births and cardiac involvement in adults is rare. Chagas disease is an infection caused by the protozoan Trypanosoma cruzi, in which one-third of the cases progress to the chronic form, and may lead to cardiac involvement, usually from the fifth decade of life onwards...
2018: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/29754651/rationale-and-methods-of-the-prospective-study-of-biomarkers-symptom-improvement-and-ventricular-remodeling-during-sacubitril-valsartan-therapy-for-heart-failure-prove-hf
#12
James L Januzzi, Javed Butler, Emmanuel Fombu, Alan Maisel, Kevin McCague, Ileana L Piña, Margaret F Prescott, Jerome B Riebman, Scott Solomon
BACKGROUND: Sacubitril/valsartan is an angiotensin receptor-neprilysin inhibitor indicated for the treatment of patients with chronic heart failure (HF) with reduced ejection fraction; however, its mechanism of benefit remains unclear. Biomarkers that are linked to ventricular remodeling, myocardial injury, and fibrosis may provide mechanistic insight and important clinical guidance regarding sacubitril/valsartan use. METHODS: This 52-week, multicenter, open-label, single-arm study is designed to (1) correlate biomarker changes with cardiac remodeling parameters, cardiovascular outcomes, and patient-reported outcome data and (2) determine short- and long-term changes in concentrations of biomarkers related to potential mechanisms of action and effects of sacubitril/valsartan therapy...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29754190/allergic-and-immunologic-perspectives-of-inflammatory-bowel-disease
#13
REVIEW
Kofi Clarke, Jayakrishna Chintanaboina
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammatory condition primarily involving the gastrointestinal tract. It includes Crohn's disease (CD), ulcerative colitis (UC), and a less common phenotype-indeterminate colitis. It is thought to result from a complex interplay of environmental, microbial, and host factors including genetic factors, although the exact mechanism is not known. Dietary factors have been shown to play a role in the pathogenesis of IBD and can potentially alter the intestinal microbiota as well as disrupt the immune function in the gut...
May 12, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29753687/istaroxime-a-positive-inotropic-agent-devoid-of-proarrhythmic-properties-in-sensitive-chronic-atrioventricular-block-dogs
#14
Alexandre Bossu, Amée Kostense, Henriette D M Beekman, Marien J C Houtman, Marcel A G van der Heyden, Marc A Vos
Current inotropic agents in heart failure therapy associate with low benefit and significant adverse effects, including ventricular arrhythmias. Istaroxime, a novel Na+ /K+ -transporting ATPase inhibitor, also stimulates SERCA2a activity, which would confer improved inotropic and lusitropic properties with less proarrhythmic effects. We investigated hemodynamic, electrophysiological and potential proarrhythmic and antiarrhythmic effects of istaroxime in control and chronic atrioventricular block (CAVB) dogs sensitive to drug-induced Torsades de Pointes arrhythmias (TdP)...
May 10, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29748349/independent-prognostic-value-of-serum-soluble-st2-measurements-in-patients-with-heart-failure-and-a-reduced-ejection-fraction-in-the-paradigm-hf-trial-prospective-comparison-of-arni-with-acei-to-determine-impact-on-global-mortality-and-morbidity-in-heart-failure
#15
Eileen O'Meara, Margaret F Prescott, Brian Claggett, Jean L Rouleau, Lu-May Chiang, Scott D Solomon, Milton Packer, John J V McMurray, Michael R Zile
BACKGROUND: Soluble ST2 (sST2) is associated with cardiac remodeling and fibrosis. In chronic heart failure, the predictive value of sST2 has not been evaluated in a model that includes both NT-proBNP (N-terminal pro-B-type natriuretic peptide) and hs-TnT (high-sensitivity cardiac troponin T), in a trial in which treatment had a major impact. Therefore, the effects of treatment on sST2 levels in PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure), the relationships between sST2 and outcomes, and the prognostic utility of various sST2 partition values were examined...
May 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29747005/is-the-adenosine-a-2b-biased-receptor-a-valuable-target-for-the-treatment-of-pulmonary-arterial-hypertension
#16
REVIEW
Mafalda Bessa-Gonçalves, Bruno Bragança, Eduardo Martins-Dias, Paulo Correia-de-Sá, Ana Patrícia Fontes-Sousa
Pulmonary arterial hypertension (PAH) is a maladaptive disorder characterized by increased pulmonary vascular resistance leading to right ventricular failure and death. Adenosine released by injured tissues, such as the lung and heart, influences tissue remodeling through the activation of adenosine receptors. Evidence regarding activation of the low-affinity A2B AR by adenosine points towards pivotal roles of this receptor in processes associated with both acute and chronic lung diseases. Conflicting results exist concerning the beneficial or detrimental roles of the A2B 'biased' receptor in right ventricular failure secondary to PAH...
May 7, 2018: Drug Discovery Today
https://www.readbyqxmd.com/read/29746142/pulmonary-vascular-involvement-in-copd-is-there-a-pulmonary-vascular-phenotype
#17
Gabor Kovacs, Alvar Agusti, Joan Albert Barberà, Bartolome Celli, Gerard Criner, Marc Humbert, Don D Sin, Norbert Voelkel, Horst Olschewski
Although often clinically unrecognized, the pulmonary circulation is frequently affected in patients with chronic obstructive pulmonary disease (COPD), and the presence of pulmonary vascular disease is associated with poor prognosis and frequent exacerbations. In most cases the presenting pulmonary hypertension (PH) is relatively mild, but in a subset of COPD patients, the presence of certain clinical features supports the existence of a "pulmonary vascular phenotype". Such a phenotype would be characterized by severe pre-capillary PH with strongly elevated pulmonary vascular resistance, moderate airflow limitation, severely decreased diffusion capacity for carbon monoxide, normo- or hypocapnia, circulatory exercise limitation and progressive right heart failure...
May 10, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29745908/local-use-of-granulocyte-macrophages-colony-stimulating-factor-in-treatment-of-chronic-diabetic-neuropathic-ulcer-case-review
#18
E Karlafti, Ch Savopoulos, A Hatzitolios, T Didangelos
One of the main causes of amputations in patients with Diabetes Mellitus patients is a chronic diabetic foot ulcer. The authors present a clinical case and discussion of a successful use of Granulocyte-Macrophages Colony Stimulating Factor (GM-CSF) treatment for the promotion of healing of a chronic diabetic foot ulcer. A 65 year-old woman was admitted to the Diabetes Center with complaints of a deep non-healing chronic foot ulcer for the last 18 months. At the examination a 5 cm ulcer on the plantar surface of the right foot was revealed...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29745006/effects-of-acute-intradialytic-exercise-on-cardiovascular-responses-in-hemodialysis-patients
#19
Jin Hee Jeong, Annabel Biruete, Bo Fernhall, Kenneth R Wilund
BACKGROUND: In patients with kidney failure requiring hemodialysis (HD) treatment, intradialytic exercise (IDEX) has been advocated for its feasibility and effectiveness in improving important health outcomes. However, IDEX as an adjunct therapeutic strategy is infrequently implemented, in part due to potential risks of IDEX, especially in patients with chronic volume overload. This study was performed to evaluate the safety of IDEX performed at different time points by examining its effect on intradialytic cardiovascular hemodynamics...
May 9, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29737434/anti-apoptosis-in-nonmyocytes-and-pro-autophagy-in-cardiomyocytes-two-strategies-against-postinfarction-heart-failure-through-regulation-of-cell-death-degeneration
#20
REVIEW
Genzou Takemura, Hiromitsu Kanamori, Hideshi Okada, Nagisa Miyazaki, Takatomo Watanabe, Akiko Tsujimoto, Kazuko Goto, Rumi Maruyama, Takako Fujiwara, Hisayoshi Fujiwara
Anti-apoptotic therapy for cardiomyocytes could be an effective strategy for preventing or treating heart failure. Notably, however, morphological evidence definitively demonstrating cardiomyocyte apoptosis has been very rare in actual heart diseases such as acute myocardial infarction and heart failure. By contrast, within the postinfarction heart, interstitial noncardiomyocytes such as granulation tissue cells do die via apoptosis to form scar tissue. Blockade of this apoptosis improves survival and mitigates ventricular remodeling and dysfunction during the chronic stage...
May 8, 2018: Heart Failure Reviews
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