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https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#1
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29436036/dobutamine-stress-echocardiography-myocardial-perfusion-scintigraphy-invasive-coronary-angiography-and-post-liver-transplantation-events-systematic-review-and-meta-analysis
#2
Jonathan Soldera, Fábio Camazzola, Santiago Rodríguez, Ajacio Brandão
The impact of coronary artery disease on the clinical course of patients enrolled for liver transplantation (LT) has changed over the years as these patients become older and sicker. The purpose of this systematic review and meta-analysis is to investigate the value of dobutamine stress echocardiography (DSE), myocardial perfusion scintigraphy (MPS), and invasive coronary angiography (ICA) in predicting cardiac events post-LT in cirrhotic patients. A literature search was conducted using Scopus, Web of Science, EMBASE, MEDLINE (via PubMed), BIREME (regional medical library of the Pan American Health Organization), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library for Systematic Reviews, and OpenGrey Repository (www...
February 12, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29432375/positive-predictive-value-of-noninvasive-stress-testing-is-poor-in-the-real-world
#3
Geetanjali Dang, Muhammad Shahreyar, Ahmet Afşin Oktay, Samian Sulaiman, Husein Husein, Ana Inashvili, Nadia Elhangouche, Preethi Subramanian, Mohammad Waqas Bashir, Aradhna Pathak, Shu B Chan, Shahriar Dadkhah
Abnormal noninvasive stress test (NIST) findings do not always correlate with angiographically significant (luminal obstruction ≥50%) coronary artery disease. Positive predictive value (PPV) of NIST in the real clinical practice is not well known. The goal of this retrospective study was to determine the PPV of NIST and assess the factors affecting PPV in a US community hospital. This study included all consecutive patients (n = 355) who underwent invasive coronary angiography after a positive NIST within ~1-year duration at our institution...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29424731/efficacy-of-cardiac-shock-wave-therapy-in-patients-with-stable-angina-the-design-of-randomized-triple-blind-sham-procedure-controlled-study
#4
Evgeny Shkolnik, Greta Burneikaite, Jelena Celutkiene, Mikhail Scherbak, Gitana Zuoziene, Birute Petrauskiene, Ekaterina Trush, Aleksandras Laucevicius, Yury Vasyuk
OBJECTIVE: Despite revascularization and optimal medical treatment (OMT), patients with angina often have a reduced quality of life due to inadequate relief from symptoms. Recent studies have shown that the application of shock waves may reduce angina symptoms and improve quality of life, exercise capacity, and myocardial perfusion due to the stimulation of angiogenesis. However, there is limited evidence due to small, single-arm, single-center studies of low to moderate quality. The purpose of this study is to evaluate the impact of cardiac shock wave therapy (CSWT) on exercise tolerance and angina symptoms in patients with coronary artery disease and objective evidence of myocardial ischemia who cannot undergo traditional revascularization and experience angina despite OMT in comparison to sham procedure...
February 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29408371/women-in-danger-detecting-coronary-artery-disease-are-there-any-sex-differences
#5
EDITORIAL
A P Patrianakos
Cardiovascular disease (CVD) is the leading cause of death in women in the western countries. Women are less likely to seek medical assistance and are often misdiagnosed, facts that increase incrementally their CVD mortality. Exercise stress test is often non diagnostic and thus dobutamine stress echocardiography represents an excellent tool in the evaluation of coronary artery disease in women. Especially with the additional use of echocardiographic contrast agents that help to overcome the technical difficulties in the evaluation of the female small,usually, cardiac chambers, dobutamine stress echocardiography seems to be the most attractive non-invasive, radiation free diagnostic imaging modality, in the daily clinical practice with a proven diagnostic and prognostic value...
February 3, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29406852/evaluating-patients-with-low-flow-low-gradient-aortic-stenosis-by-dobutamine-echocardiography-it-s-complicated
#6
EDITORIAL
Paul A Grayburn
No abstract text is available yet for this article.
February 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29406851/dobutamine-stress-echocardiography-for-management-of-low-flow-low-gradient-aortic-stenosis
#7
Mohamed-Salah Annabi, Eden Touboul, Abdellaziz Dahou, Ian G Burwash, Jutta Bergler-Klein, Maurice Enriquez-Sarano, Stefan Orwat, Helmut Baumgartner, Julia Mascherbauer, Gerald Mundigler, João L Cavalcante, Éric Larose, Philippe Pibarot, Marie-Annick Clavel
BACKGROUND: In the American College of Cardiology/American Heart Association guidelines, patients are considered to have true-severe stenosis when the mean gradient (MG) is ≥40 mm Hg with an aortic valve area (AVA) ≤1 cm 2 during dobutamine stress echocardiography (DSE). However, these criteria have not been previously validated. OBJECTIVES: The aim of this study was to assess the value of these criteria to predict the presence of true-severe AS and the occurrence of death in patients with low-flow, low-gradient aortic stenosis (LF-LG AS)...
February 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29402710/safety-and-utility-of-dobutamine-and-pressure-wire-use-in-the-hemodynamic-assessment-of-low-flow-low-gradient-aortic-stenosis-with-reduced-left-ventricular-ejection-fraction
#8
Zaher Fanari, Prasad C Gunasekaran, Arslan Shaukat, Sumaya Hammami, Buddhadeb Dawn, Mark Wiley, Peter Tadros
BACKGROUND: The ACC/AHA guidelines recommend low-dose dobutamine challenge for hemodynamic assessment of the severity of AS in patients with low flow, low gradient aortic stenosis with reduced ejection fraction (EF) (LFLG-AS; stage D2). Inherent pitfalls of echocardiography could result in inaccurate aortic valve areas (AVA), which have downstream prognostic implications. Data on the safety and efficacy of coronary pressure wire and fluid-filled catheter use for low dose dobutamine infusion is sparse...
October 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29389246/increasing-cerebral-blood-flow-reduces-the-severity-of-central-sleep-apnea-at-high-altitude
#9
Keith R Burgess, Samuel J E Lucas, Katie Me Burgess, Kate E Sprecher, Joseph Donnelly, Aparna S Basnet, Michael M Tymko, Trevor A Day, Kurt Jason Smith, Nia C S Lewis, Philip Ainslie
Earlier studies have indicated an important role for cerebral blood flow in the pathophysiology of central sleep apnea (CSA) at high altitude, but were not decisive. To test the hypothesis that pharmacologically altering cerebral blood flow (CBF) without altering arterial blood gas (ABGs) values would alter the severity of CSA at high altitude, we studied 11 healthy volunteers. (8M, 3F; 31{plus minus}7 years) in a randomized placebo-controlled single-blind study at 5,050 metres in Nepal. CBF was increased by intravenous (iv) acetazolamide (Az; 10mg/kg) plus iv dobutamine (Dob) infusion (2-5 ug/kg/min) and reduced by oral indomethacin (Indo; 100mg)...
February 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29377609/use-of-the-fractional-excretion-of-urea-in-an-azotemic-nonoliguric-state-type-1-cardiorenal-syndrome
#10
James B Diskin, Christopher Brandon Walker, Michael D Oberle, Charles J Diskin
The fractional excretion of urea is a useful tool to evaluate renal function in oliguric states; however, it remains unexplored in nonoliguric states. We evaluated its use to predict responses in patients with type 1 cardiorenal syndrome. This was a prospective observational study of 116 patients with type 1 cardiorenal syndrome referred over a 4-year period. Fractional excretion of urea and sodium, ejection fraction, mean arterial pressure, age, sex, diabetes, brain natriuretic peptide (BNP), serum sodium and blood urea nitrogen were analyzed for effects upon serum creatinine and survival...
January 26, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29376560/inotropic-agents-and-vasodilator-strategies-for-the-treatment-of-cardiogenic-shock-or-low-cardiac-output-syndrome
#11
REVIEW
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
https://www.readbyqxmd.com/read/29368192/cirrhotic-cardiomyopathy-is-less-prevalent-in-patients-with-budd-chiari-syndrome-than-cirrhosis-of-liver
#12
Akash Shukla, Pratin Bhatt, Deepak Kumar Gupta, Tejas Modi, Jatin Patel, Milind Phadke, Krantikumar Rathod, Megha Meshram, S J Bhatia
BACKGROUND AND AIM: Cirrhotic cardiomyopathy (CCM) is associated with high mortality after transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation in patients with cirrhosis. There is no data about the prevalence or impact of CCM in Budd-Chiari syndrome (BCS). We assessed the prevalence of CCM in patients with BCS and its impact on outcome after radiological intervention. METHODS: Thirty-three consecutive patients with BCS (15 men) and 33 controls with hepatitis B-related cirrhosis (18 men, matched for Child-Pugh score) were evaluated with baseline electrocardiography (ECG), echocardiography (ECHO) and dobutamine stress ECHO, and ECG (DSE)...
January 24, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29365499/dynamics-of-indicators-of-longitudinal-left-ventricular-systolic-function-in-patients-with-acute-myocardial-infarction-during-stress-echocardiography-with-dobutamine
#13
Azizjon Nizomov, Sirojiddin Kenjaev, Majid Kenjaev, Malika Mukhamedova
No abstract text is available yet for this article.
August 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29357490/chronic-low-intensity-exercise-attenuates-cardiomyocyte-contractile-dysfunction-and-impaired-adrenergic-responsiveness-in-aortic-banded-mini-swine
#14
Jessica A Hiemstra, Adam B Veteto, Michelle D Lambert, T Dylan Olver, Brian S Ferguson, Kerry S McDonald, Craig A Emter, Timothy L Domeier
Exercise improves clinical outcomes in patients diagnosed with heart failure with reduced ejection fraction (HFrEF), in part via beneficial effects on cardiomyocyte Ca2+ cycling during excitation-contraction coupling (ECC). However, limited data exist regarding the effects of exercise training on cardiomyocyte function in patients diagnosed with heart failure with preserved ejection fraction (HFpEF). The purpose of this study was to investigate cardiomyocyte Ca2+ handling and contractile function following chronic low-intensity exercise training in aortic-banded miniature swine, and test the hypothesis that low-intensity exercise improves cardiomyocyte function in a large animal model of pressure overload...
January 4, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29353048/cardiac-events-after-non-cardiac-surgery-in-patients-undergoing-pre-operative-dobutamine-stress-echocardiography-findings-from-the-mayo-poce-dse-investigators
#15
R Jay Widmer, Michael W Cullen, Bradley R Salonen, Karna K Sundsted, David Raslau, Arya B Mohabbat, Brian M Dougan, D Mike Bierle, Donna K Lawson, A Jimmy Widmer, Mary Bundrick, Prakriti Gaba, Rene Tellez, Darrell R Schroeder, Robert B McCully, Karen F Mauck
BACKGROUND: Current guidelines support the use of dobutamine stress echocardiography (DSE) prior to non-cardiac surgery in higher risk patients who are unable to perform at least 4 metabolic equivalents of physical activity. We evaluated post-operative outcomes of patients in different operative risk categories after pre-operative DSE. METHODS: We collected data from the medical record on 4,494 patients from January 1, 2006 to December 31, 2011 who had DSE up to 90 days prior to a non-cardiac surgery...
January 15, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#16
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29340989/gated-spect-myocardial-perfusion-imaging-with-cadmium-zinc-telluride-detectors-allows-real-time-assessment-of-dobutamine-stress-induced-wall-motion-abnormalities
#17
Rene Nkoulou, Mathias Wolfrum, Aju P Pazhenkottil, Michael Fiechter, Ronny R Buechel, Oliver Gaemperli, Philipp A Kaufmann
BACKGROUND: Left ventricular (LV) ejection fraction (EF) during high dobutamine stress (HD) by real-time gated-SPECT myocardial perfusion imaging (MPI) on a cadmium-zinc-telluride (CZT) gamma camera was validated versus cardiac magnetic resonance imaging (CMR). METHODS AND RESULTS: After injecting 99mTc-tetrofosmin (320 MBq) in 50 patients (mean age 64 +/- 11 years), EF at rest and post-stress as well as relevant changes in EF at HD (ΔEF ≥ 5%) were assessed. CZT and CMR rest EF values yielded an excellent correlation and agreement (r = 0...
January 16, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29340539/the-spectrum-of-cardiovascular-effects-of-dobutamine-from-healthy-subjects-to-septic-shock-patients
#18
Arnaldo Dubin, Bernardo Lattanzio, Luis Gatti
Dobutamine is the inotrope most commonly used in septic shock patients to increase cardiac output and correct hypoperfusion. Although some experimental and clinical studies have shown that dobutamine can improve systemic and regional hemodynamics, other research has found that its effects are heterogenous and unpredictable. In this review, we analyze the pharmacodynamic properties of dobutamine and its physiologic effects. Our goal is to show that the effects of dobutamine might differ between healthy subjects, in experimental and clinical cardiac failure, in animal models and in patients with septic shock...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29338996/incidence-and-predictors-of-postoperative-need-for-high-dose-inotropic-support-in-patients-undergoing-cardiac-surgery-for-infective-endocarditis
#19
Alessandro Belletti, Stephan Jacobs, Giovanni Affronti, Alexander Mladenow, Giovanni Landoni, Volkmar Falk, Felix Schoenrath
OBJECTIVE: Patients with infective endocarditis undergoing cardiac surgery are a high-risk population. Few data on incidence and predictors of need for high-dose inotropic support in this setting are currently available. DESIGN: Retrospective study. SETTING: Tertiary-care hospital. PARTICIPANTS: Ninety consecutive patients undergoing cardiac surgery for infective endocarditis. INTERVENTIONS: None...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29326534/is-exercise-training-appropriate-for-patients-with-advanced-heart-failure-receiving-continuous-inotropic-infusion-a-review
#20
REVIEW
Eisuke Amiya, Masanobu Taya
Exercise-based rehabilitation programs have been reported to have beneficial effects for patients with heart failure. However, there is little evidence about whether this is the case in patients with more severe heart failure. In particular, there is a question in the clinical setting whether patients with advanced heart failure and continuous inotropic infusion should be prescribed exercise training. In contrast, many studies conclude that prolonged immobility associated with heart failure profoundly impairs physical function and promotes muscle wasting that could further hasten the course of heart failure...
2018: Clinical Medicine Insights. Cardiology
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