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Management of heart failure

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https://www.readbyqxmd.com/read/28649439/mechanisms-of-action-of-sacubitril-valsartan-on-cardiac-remodeling-a-systems-biology-approach
#1
Oriol Iborra-Egea, Carolina Gálvez-Montón, Santiago Roura, Isaac Perea-Gil, Cristina Prat-Vidal, Carolina Soler-Botija, Antoni Bayes-Genis
Sacubitril/Valsartan, proved superiority over other conventional heart failure management treatments, but its mechanisms of action remains obscure. In this study, we sought to explore the mechanistic details for Sacubitril/Valsartan in heart failure and post-myocardial infarction remodeling, using an in silico, systems biology approach. Myocardial transcriptome obtained in response to myocardial infarction in swine was analyzed to address post-infarction ventricular remodeling. Swine transcriptome hits were mapped to their human equivalents using Reciprocal Best (blast) Hits, Gene Name Correspondence, and InParanoid database...
2017: NPJ Systems Biology and Applications
https://www.readbyqxmd.com/read/28648534/promising-outcome-of-anatomic-correction-of-corrected-transposition-of-the-great-arteries
#2
Viktor Hraska, Mathieu Vergnat, Peter Zartner, Chris Hart, Phillip Suchowerskyj, Benjamin Bierbach, Ehrenfried Schindler, Martin Schneider, Boulos Asfour
BACKGROUND: Anatomic correction of corrected transposition of the great arteries with associated lesions, utilizing the morphologic left ventricle as a systemic pumping chamber, is the preferred method in many centers. The purpose of this study was to analyze functional outcome after anatomic correction. METHODS: Between Jan 1997 and May 2016, 63 patients with corrected transposition of the great arteries and associated lesions underwent anatomic correction. Forty-two patients (67%) underwent palliation before correction, including 14 patients (22%) who required training of systemic ventricle...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648436/angiotensin-converting-enzyme-inhibitors-and-receptor-blockers-in-heart-failure-and-chronic-kidney-disease-demystifying-controversies
#3
REVIEW
Kader Muneer, Anishkumar Nair
In clinical setting, congestive heart failure (CHF) and chronic kidney disease (CKD) often co-exist in patients due to common underlying predisposing factors. An intricate equilibrium between the cardiovascular and renal system is maintained through rennin angiotensin-aldosterone axis and autonomic nervous system. Consequent to favorable hemodynamic modification, angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocking (ARB) therapy have proven to be an indispensable aspect of heart failure management with morbidity and mortality benefit...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28648429/ddd-pacemaker-for-severe-heart-failure-alternate-to-crt
#4
N C Krishnamani
Patients with severe systolic Heart Failure continue to have poor quality of life and increased mortality in spite of optimal medical management. Cardiac Resynchronization Therapy [CRT] is promising modality in patients with systolic heart failure and electrocardiographic [ECG] evidence of left bundle branch block [LBBB]. Cost issues continue to elude many deserving cases of this therapy in our society. Relatively cost effective Dual chamber pacing [DDD] with right atrial and isolated left ventricular pacing [RA-LV] can be a good alternative...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#5
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28648204/long-term-prognosis-of-chronic-kidney-disease-in-non-st-elevation-acute-coronary-syndrome-treated-with-invasive-strategy
#6
Ildefonso Roldán Torres, Inmaculada Salvador Mercader, Claudia Cabadés Rumbeu, José Luis Díez Gil, José Ferrando Cervelló, Marta Monteagudo Viana, Rubén Fernández Galera, Vicente Mora Llabata
BACKGROUND AND AIM: Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular outcomes after non-ST elevation acute coronary syndrome (NSTEACS). However, the information available on this specific population, is scarce. We evaluate the impact of CKD on long-term prognosis in patients with NSTEACS managed with invasive strategy. METHODS: We conduct a prospective registry of patients with NSTEACS and coronary angiography. CKD was defined as a glomerular filtration rate < 60ml/min/1,73m(2)...
May 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#7
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28647113/feline-congestive-heart-failure-current-diagnosis-and-management
#8
REVIEW
Etienne Côté
Congestive heart failure (CHF) is a well-known disorder in feline practice, having been recognized as the most common clinical syndrome in cats with hypertrophic cardiomyopathy, for example. This article identifies the reasons that an accurate diagnosis of CHF is important and the means by which to obtain one; pharmacologic and nonpharmacologic methods for controlling signs of CHF; and recommendations for follow-up evaluations, monitoring, and troubleshooting.
June 21, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28647112/arrhythmogenic-right-ventricular-cardiomyopathy-in-the-boxer-dog-an-update
#9
REVIEW
Kathryn M Meurs
Arrhythmogenic right ventricular cardiomyopathy is an inheritable form of myocardial disease characterized most commonly by ventricular tachycardias, syncope, and sometimes systolic dysfunction and heart failure. A genetic mutation in the striatin gene has been identified in many affected dogs. Dogs with only one copy of the mutation (heterozygous) have a variable prognosis with many dogs remaining asymptomatic or successfully managed on antiarrhythmic drugs for years. Dogs that are homozygous for the mutation seem to have a worse prognosis...
June 21, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28646467/symptom-management-challenges-in-heart-failure-pharmacotherapy-considerations
#10
REVIEW
Diana Stewart, Mary Lynn McPherson
Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28646466/effects-of-catheter-based-renal-denervation-on-heart-failure-with-reduced-ejection-fraction-a-systematic-review-and-meta-analysis
#11
REVIEW
Hidekatsu Fukuta, Toshihiko Goto, Kazuaki Wakami, Nobuyuki Ohte
Despite the recent advances in the management of heart failure, the mortality of heart failure patients remains high. It is of urgent need to develop new therapy for heart failure. Heart failure is characterized by increased sympathetic activity, and chronic sympathetic activation is involved in the maintenance of the pathological state. Catheter-based renal denervation (RDN) has emerged as an invasive but safe approach that can reduce sympathetic activation. Studies have reported inconsistent results regarding the effect of RDN in heart failure patients due to limited power with small sample sizes...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28645959/formal-consensus-to-identify-clinically-important-changes-in-management-resulting-from-the-use-of-cardiovascular-magnetic-resonance-cmr-in-patients-who-activate-the-primary-percutaneous-coronary-intervention-ppci-pathway
#12
Maria Pufulete, Rachel C Brierley, Chiara Bucciarelli-Ducci, John P Greenwood, Stephen Dorman, Richard A Anderson, Jessica Harris, Elisa McAlindon, Chris A Rogers, Barnaby C Reeves
OBJECTIVE: To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. DESIGN: Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus)...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#13
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#14
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28642290/coronary-events-complicating-infective-endocarditis
#15
Virginie Roux, Erwan Salaun, Christophe Tribouilloy, Sandrine Hubert, Yohann Bohbot, Jean-Paul Casalta, Pierre-Antoine Barral, Dan Rusinaru, Frederique Gouriet, Cecile Lavoute, Julie Haentjens, Mathieu Di Biscegli, Aurelie Dehaene, Sebastien Renard, Anne-Claire Casalta, Julie Pradier, Jean-Francois Avierinos, Alberto Riberi, Marc Lambert, Frederic Collart, Alexis Jacquier, Franck Thuny, Laurence Camoin-Jau, Hubert Lepidi, Didier Raoult, Gilbert Habib
OBJECTIVE: Acute coronary syndromes (ACS) are a rare complication of infective endocarditis (IE). Only case reports and small studies have been published to date. We report the largest series of ACS in IE. The aim of our study was to describe the incidence and mechanisms of ACS associated with IE, to assess their prognostic impact and to describe their management. METHODS: In a bicentre prospective observational cohort study, all patients with a definite diagnosis of IE were prospectively included...
June 22, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#16
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28641712/wireless-the-life-and-death-of-guglielmo-marconi
#17
EDITORIAL
Harold Smulyan, Robert S Pinals, Lisa Pinals, Daniel Villarreal
With little training in physics, Guglielmo Marconi developed the invention that stunned the world by wirelessly connecting ships and continents. Ten years before his death, he sustained a myocardial infarction followed by unmistakable angina pectoris. His personality and unhappy family life limited his ability to cope with his disease and to deal with Italy's most respected physicians. But their descriptions of his diagnosis and management are surprisingly few. Poor record keeping, intentional news suppression of his failing health or limited medical opportunities could be the reason for this lack of information...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28641514/clinically-relevant-biomarkers-in-acute-heart-failure-an-update
#18
Agnibh Mukherji, Uzair Ansari, Martin Borggrefe, Ibrahim Akin, Michael Behnes
Acute heart failure (AHF) has been one of the fields, where owing to difficulties in diagnosis, prognostic stratification and management the associated morbidity and mortality remains unusually high. The advent of novel biomarkers apart from the traditional B-type natriuretic peptide and N-terminal proBNP involved in myocardial injury, neuro-hormonal activation, and ventricular remodeling augurs immense hope in redefining our approach towards AHF. METHODS: Biomarkers like midregional proatrial natriuretic peptide, soluble ST2, highly-sensitive troponin, and midregional proadrenomedullin are some such examples that have passed various stages of substantiation while there is an array of potential biomarkers in nascent stages like osteopontin, CTGF, GDF-15 and TGF beta-1 awaiting further reiteration...
June 22, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28639957/pulmonary-arterial-hypertension-induced-by-tyrosine-kinase-inhibitors
#19
Jason Weatherald, Marie-Camille Chaumais, David Montani
PURPOSE OF REVIEW: Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of several neoplastic conditions; however, pulmonary arterial hypertension (PAH) has been reported as a complication of TKIs, predominantly with dasatinib. Recent studies have elucidated the potential mechanisms of TKI-induced PAH and have better clarified the long-term outcomes. RECENT FINDINGS: In addition to the known association between dasatinib and PAH, several other TKIs have recently been reported to cause PAH, including ponatinib, bosutinib and lapatinib...
July 20, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28639873/anesthetic-management-of-patients-undergoing-percutaneous-endocardial-and-epicardial-left-atrial-appendage-occlusion
#20
Zeena Husain, Payam Safavi-Naeini, Abdi Rasekh, Mehdi Razavi, Charles D Collard, James M Anton, Daniel A Tolpin
Atrial fibrillation is the most common cardiac arrhythmia in adults affecting almost 6 million adults in the United States. The 2 most common comorbidities associated with atrial fibrillation are heart failure and thromboembolic events. Heart failure symptoms may be treated with rate control, antiarrhythmic medications or by catheter ablation. Unfortunately, despite optimal medical management, thromboembolic events still occur. Recently, there has been a great deal of interest and innovation in finding an alternative to chronic anticoagulation...
June 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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