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https://www.readbyqxmd.com/read/29050744/-stress-dobutamine-echocardiography-or-resting-strain-rate-imaging-to-unveil-an-early-symptomatic-diabetic-cardiomyopathy
#1
F Aboukhoudir, I Aboukhoudir, S Rekik
Diabetes mellitus has been associated with changes in the structure and function of the myocardium manifesting in the early stages of the disease as subtle systolic and diastolic dysfunction; myocardial strain imaging has recently been favored over dobutamine stress echocardiography for early detection of diabetic cardiomyopathy. We report a case of an elderly diabetic patient presenting with pulmonary edema in whom at rest echocardiographic parameters including strain rate were all within normal range, while dobutamine stress echocardiography induced a deep systolic deterioration unmasking an early-stage diabetic cardiomyopathy...
October 16, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29037800/clinical-comparison-of-dexmedetomidine-and-medetomidine-for-isoflurane-balanced-anaesthesia-in-horses
#2
Muriel Sacks, Simone K Ringer, Andrea S Bischofberger, Sabrina M Berchtold, Regula Bettschart-Wolfensberger
OBJECTIVE: To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. STUDY DESIGN: Prospective, blinded, randomized clinical study. ANIMALS: Sixty healthy adult warm blood horses undergoing elective surgery. METHODS: Thirty horses each were sedated with dexmedetomidine 3.5 μg kg(-1) (group DEX) or medetomidine 7 μg kg(-1) (group MED) intravenously...
April 26, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29033349/a-polymorphism-in-the-glucocorticoid-receptor-gene-is-associated-with-refractory-hypotension-in-premature-infants
#3
Kei Ogasawara, Maki Sato, Koichi Hashimoto, Takashi Imamura, Hayato Go, Mitsuaki Hosoya
BACKGROUND: Glucocorticoids play an important role in endocrine control. The association of glucocorticoid receptor (GR) gene polymorphisms with altered sensitivity to glucocorticoid therapy has been reported in adults. However, there are few such reports in infants. The present study analyzed the prevalence of four GR polymorphisms in preterm infants born before 30 weeks of gestation and determined the associations between these polymorphisms and clinical outcomes in the infants. METHODS: Totally, 41 preterm infants born at two hospitals in Fukushima were retrospectively screened for the presence of four GR gene polymorphisms, using a TaqMan single-nucleotide polymorphism genotyping assay...
September 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29031332/right-ventricular-function-during-pharmacological-and-exercise-stress-testing-in-horses
#4
A Decloedt, D De Clercq, S Ven, L Vera, G van Loon
The disproportionate rise of pulmonary artery pressure compared to systemic blood pressure during exercise can lead to detrimental right ventricular remodelling in endurance athletes. Horses may act as an extreme model of these athletic cardiovascular adaptations, as they show a three fold increase in pulmonary pressures during exercise. Right ventricular function was examined in ten healthy horses using post-exercise and pharmacological stress echocardiography in a randomised cross-over design. Exercise testing was performed on a treadmill while pharmacological testing was performed using an atropine-dobutamine infusion...
September 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29030210/continuous-cardiac-inotropes-in-patients-with-end-stage-heart-failure-an-evolving-experience
#5
Kasey Malotte, Agafe Saguros, Hunter Groninger
Heart failure experts recommend initiation of continuous inotrope therapy, such as milrinone or dobutamine, for clinically decompensating patients with stage D heart failure. Although originally intended to serve solely as a bridge to more definitive surgical therapies, more and more patients are receiving inotrope therapy for purely palliative purposes. In these cases, questions arise regarding care at the end of life. What criteria determine ongoing clinical benefit? Should the inotrope be continued until death? Should inotrope dosing be increased within recommended guidelines to improve symptoms? What is the role of inotropes in hospice care? Here, we describe such a case as a springboard to contemplate the evolving role of inotrope therapies and how hospice and palliative providers may interface with this rapidly developing face of advanced heart failure care...
October 10, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29029934/ability-of-pulse-wave-transit-time-to-detect-changes-in-stroke-volume-and-to-estimate-cardiac-output-compared-to-thermodilution-technique-in-isoflurane-anaesthetised-dogs
#6
H Sano, J P Chambers
OBJECTIVE: To evaluate the ability of pulse wave transit time (PWTT) to detect changes in stroke volume (SV) and to estimate cardiac output (CO) compared with the thermodilution technique in isoflurane-anaesthetized dogs. STUDY DESIGN: Prospective, experimental study. ANIMALS: Eight adult laboratory dogs. METHODS: The dogs were anaesthetized with isoflurane and mechanically ventilated. Reference CO (TDCO) was measured via a pulmonary artery catheter using the thermodilution technique and reference SV (TDSV) was calculated...
April 26, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29021259/preload-stress-echocardiography-predicts-outcomes-in-patients-with-preserved-ejection-fraction-and-low-gradient-aortic-stenosis
#7
Kenya Kusunose, Hirotsugu Yamada, Susumu Nishio, Yuta Torii, Yukina Hirata, Hiromitsu Seno, Yoshihito Saijo, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata
BACKGROUND: The projected aortic valve area (AVAproj) at a normal transvalvular flow rate using dobutamine is helpful to determine the actual severity of aortic stenosis (AS) and to predict risk of adverse events in low-gradient AS cases with unclear surgical indication. Our study aimed to identify the independent and incremental value of preload stress echocardiography-derived AVAproj to predict outcomes in patients with preserved ejection fraction and low-gradient AS. METHODS AND RESULTS: We prospectively performed echocardiographic studies in 79 patients with low-gradient AS (age, 77±7 years; 30% men) with preload stress echocardiography using leg positive pressure...
October 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28986357/excess-omega-6-fatty-acids-influx-in-aging-drives-metabolic-dysregulation-electrocardiographic-alterations-and-low-grade-chronic-inflammation
#8
Vasundhara Kain, Kevin A Ingle, Maureen Kachman, Heidi Baum, Gobinath Shanmugam, Namakkal S Rajasekaran, Martin E Young, Ganesh V Halade
Maintaining a balance of omega-6 and -3 fatty acids is essential for cardiac health. Current omega-6 and omega-3 fatty acids in the American diet has shifted from the ideal ratio of 2:1 to almost 20:1, while there is a body of evidence suggest the negative impact of such a shift in younger organisms, the underlying age-related metabolic signaling in response to the excess influx of omega-6 is incompletely understood. In the current study, young (6-month-old) and aging (≥18-month-old) mice were fed for two months with omega-6 enriched diet...
October 6, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28980409/stress-test-to-stemi-utility-of-coronary-cta-in-the-diagnosis-and-management-of-anomalous-right-coronary-artery-from-the-left-coronary-cusp
#9
Anshuman Das, Ajay Joseph, Neeraj Jolly, Dinesh K Kalra
A 42-year-old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography (DSE), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery (RCA). Coronary CT angiography (CCTA) confirmed an anomalous RCA arising from the left coronary cusp with a slit-like ostium and interarterial course (ARCA-LCC-IA). Herein, we review the extant literature on ARCA-LCC-IA, its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management...
October 2017: Echocardiography
https://www.readbyqxmd.com/read/28967164/negative-predictive-value-of-dobutamine-stress-echocardiography-for-perioperative-risk-stratification-in-patients-with-cardiac-risk-factors-and-reduced-exercise-capacity-undergoing-non-cardiac-surgery
#10
Gus Go, Kathy T Davies, Cara O'Callaghan, Wendy Senior, Karam Kostner, Narelle Fagermo, Sandhir B Prasad
BACKGROUND: Guidelines recommend functional testing for myocardial ischaemia in the perioperative setting in patients with >1 recognised cardiac risk factors and self-reported reduced exercise capacity. We sought to determine the clinical utility of dobutamine stress echocardiography (DSE) for perioperative risk stratification in patients undergoing major noncardiac surgery. METHODS: Data on 79 consecutive patients undergoing DSE for perioperative risk stratification at a single centre was retrospectively reviewed to determine rates of Major Adverse Cardiac Events (MACE) during the index hospitalisation and 30 days post discharge...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28966160/association-between-fractional-flow-reserve-instantaneous-wave-free-ratio-and-dobutamine-stress-echocardiography-in-patients-with-stable-coronary-artery-disease
#11
Vasileios F Panoulas, Kalliopi Keramida, Olga Boletti, Michail I Papafaklis, Dimitris Flessas, Maria Petropoulou, Petros Nihoyannopoulos
AIMS: The association between fractional flow reserve (FFR) and dobutamine stress echocardiography (DSE) in real world stable angina patients is scant and controversial whereas no such comparison exists with instantaneous wave free ratio (iFR). The current retrospective study aimed to investigate the associations amongst these modalities in patients with stable coronary artery disease (CAD) and intermediate coronary lesions. METHODS AND RESULTS: We studied 62 consecutive stable angina patients who underwent DSE and subsequently coronary angiography with FFR (in all 62) and iFR (in 46/62 patients) assessment of intermediate single vessel lesions between 2014-2015...
October 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28949414/age-dependent-electrocardiographic-changes-in-pgc-1%C3%AE-deficient-murine-hearts
#12
Shiraz Ahmad, Haseeb Valli, Samantha C Salvage, Andrew A Grace, Kamalan Jeevaratnam, Christopher L-H Huang
Increasing evidence implicates chronic energetic dysfunction in human cardiac arrhythmias. Mitochondrial impairment through Pgc-1β knockout is known to produce a murine arrhythmic phenotype. However, the cumulative effect of this with advancing age and its electrocardiographic basis has not been previously studied. Young (12-16 weeks) and aged (>52 weeks), WT (n = 5 and 8) and Pgc-1β(-/-) (n = 9 and 6), mice were anaesthetised and used for electrocardiographic (ECG) recordings. Time intervals separating successive ECG deflections were analysed for differences between groups before and after β1-adrenergic (intraperitoneal dobutamine 3 mg/kg) challenge...
September 26, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28948299/-cardiogenic-shock-current-evidence
#13
H Thiele
This CME article addresses the pathophysiology, incidence, current survival outcome and treatment options for patients with cardiogenic shock as a complication of acute myocardial infarction. The shock spiral of left heart failure due to cardiac infarction, subsequent vasoconstriction and paradoxical vasodilation due to the systemic inflammation response syndrome (SIRS) is a vicious circle which must be interrupted. Treatment focuses on the evidence from randomized clinical trials and the current guideline recommendations...
September 25, 2017: Herz
https://www.readbyqxmd.com/read/28925895/cardiovascular-drug-therapy-for-human-newborn-review-of-pharmacodynamic-data
#14
Ebru Ergenekon, Héctor Rojas-Anaya, María Carmen Bravo, Charalampos Kotidis, Liam Mahoney, Heike Rabe
BACKGROUND: Circulatory failure in preterm and term newborn infants is commonly treated with inotropes or vasoactive medications. In this structured literature review, the available data on pharmacodynamic effects of the inotropes adrenaline, dobutamine, dopamine, levosimendan, milrinone, noradrenaline, and the vasoactive drugs vasopressin and hydrocortisone are presented. METHODS: Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria which were human clinical trials published after 2000...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28916637/effect-of-increases-in-cardiac-contractility-on-cerebral-blood-flow-in-humans
#15
Shigehiko Ogoh, Gilbert Moralez, Takuro Washio, Satyam Sarma, Michinari Hieda, Steven A Romero, Matthew N Cramer, Manabu Shibasaki, Craig G Crandall
The effect of acute increases in cardiac contractility on cerebral blood flow (CBF) remains unknown. We hypothesized that the external carotid artery (ECA) downstream vasculature modifies the direct influence of acute increases in heart rate and cardiac function on CBF regulation. Twelve healthy subjects received two infusions of dobutamine (first a low dose; 5 μg/kg/min and then a high dose; 15 μg/kg/min) for 12 min each. Cardiac output, blood flow through the internal carotid artery (ICA) and ECA and echocardiographic measurements were performed during dobutamine infusions...
September 15, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#16
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28911895/con-dynamic-left-ventricular-outflow-tract-obstruction-should-be-considered-an-unexpected-finding-in-patients-with-end-stage-liver-disease-undergoing-dobutamine-stress-echocardiography-in-preparation-for-liver-transplantation
#17
Sandeep Khanna, Ronak Raval, Ihab Dorotta
No abstract text is available yet for this article.
April 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28894151/the-effects-of-ageing-and-adrenergic-challenge-on-electrocardiographic-phenotypes-in-a-murine-model-of-long-qt-syndrome-type-3
#18
Karan R Chadda, Shiraz Ahmad, Haseeb Valli, Ingrid den Uijl, Ali Bak Al-Hadithi, Samantha C Salvage, Andrew A Grace, Christopher L-H Huang, Kamalan Jeevaratnam
Long QT Syndrome 3 (LQTS3) arises from gain-of-function Nav1.5 mutations, prolonging action potential repolarisation and electrocardiographic (ECG) QT interval, associated with increased age-dependent risk for major arrhythmic events, and paradoxical responses to β-adrenergic agents. We investigated for independent and interacting effects of age and Scn5a+/ΔKPQ genotype in anaesthetised mice modelling LQTS3 on ECG phenotypes before and following β-agonist challenge, and upon fibrotic change. Prolonged ventricular recovery was independently associated with Scn5a+/ΔKPQ and age...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28887315/inorganic-nitrate-in-angina-study-a-randomized-double-blind-placebo-controlled-trial
#19
Konstantin Schwarz, Satnam Singh, Satish K Parasuraman, Amelia Rudd, Lee Shepstone, Martin Feelisch, Magdalena Minnion, Shakil Ahmad, Melanie Madhani, John Horowitz, Dana K Dawson, Michael P Frenneaux
BACKGROUND: In this double-blind randomized placebo-controlled crossover trial, we investigated whether oral sodium nitrate, when added to existing background medication, reduces exertional ischemia in patients with angina. METHODS AND RESULTS: Seventy patients with stable angina, positive electrocardiogram treadmill test, and either angiographic or functional test evidence of significant ischemic heart disease were randomized to receive oral treatment with either placebo or sodium nitrate (600 mg; 7 mmol) for 7 to 10 days, followed by a 2-week washout period before crossing over to the other treatment (n=34 placebo-nitrate, n=36 nitrate-placebo)...
September 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28865773/in-vivo-characterization-of-the-murine-venous-system-before-and-during-dobutamine-stimulation-implications-for-preclinical-models-of-venous-disease
#20
Olivia R Palmer, Calvin B Chiu, Amos Cao, Ulrich M Scheven, Jose A Diaz, Joan M Greve
Although widely used as a preclinical model for studying venous diseases, there is a scarcity of in vivo characterizations of the naïve murine venous system. Additionally, previous studies on naïve veins (ex vivo) have not included the influence of surrounding structures and biomechanical forces. Using MRI, we noninvasively quantified the cross-sectional area, cyclic strain, and circularity of the venous system in young and old, male and female C57BL/6 mice. We investigated the most common venous locations used to perform venous disease research: the common jugular vein, suprarenal inferior vena cava (IVC), infrarenal IVC, common iliac vein, and common femoral vein...
September 1, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
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