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https://www.readbyqxmd.com/read/27920128/forward-and-backward-pressure-waveform-morphology-in-hypertension
#1
Ye Li, Haotian Gu, Henry Fok, Jordi Alastruey, Philip Chowienczyk
We tested the hypothesis that increased pulse wave reflection and altered backward waveform morphology contribute to increased pulse pressure in subjects with higher pulse pressure compared with lower pulse pressure and to actions of vasoactive drugs to increase pulse pressure. We examined the relationship of backward to forward wave morphology in 158 subjects who were evaluated for hypertension (including some normotensive subjects) divided into 3 groups by central pulse pressure: group 1, 33±6.5 mm Hg; group 2, 45±4...
December 5, 2016: Hypertension
https://www.readbyqxmd.com/read/27916236/strain-imaging-with-a-bull-s-eye-map-for-detecting-significant-coronary-stenosis-during-dobutamine-stress-echocardiography
#2
Li-Tan Yang, Yuichiro Kado, Yasufumi Nagata, Kyoko Otani, Yutaka Otsuji, Masaaki Takeuchi
BACKGROUND: Accurate visual assessment of wall motion during dobutamine stress echocardiography (DSE) requires expertise; strain stress echocardiography thus has potential for the objective and reliable evaluation of stress-induced wall motion abnormalities. The aim of this study was to test the hypothesis that strain imaging also requires expertise. Diagnostic accuracy for significant coronary artery disease was compared between visual and strain analysis with a bull's-eye map, and the effect of expertise on readers' accuracy during DSE was determined...
December 1, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#3
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27909752/erratum-to-a-literature-review-of-the-pharmacokinetics-and-pharmacodynamics-of-dobutamine-in-neonates
#4
Liam Mahoney, Geetika Shah, David Crook, Hector Rojas-Anaya, Heike Rabe
No abstract text is available yet for this article.
December 1, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27909712/myocardial-perfusion-spect-2015-in-germany-results-of-the-7th-survey
#5
Oliver Lindner, Wolfgang Burchert, Wolfgang Schäfer, Marcus Hacker
AIM: The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine presents the results of the 7th survey of myocardial perfusion SPECT (MPS) of the reporting year 2015. METHOD: 268 questionnaires (173 practices [PR], 67 hospitals [HO], 28 university hospitals [UH]) were evaluated. Results of the last survey from 2012 are set in squared brackets. RESULTS: MPS of 121 939 [105 941] patients were reported. 98 % [95 %] of all MPS were performed with Tc-99m radiopharmaceuticals and 2 % [5 %] with Tl-201...
December 2, 2016: Nuklearmedizin. Nuclear Medicine
https://www.readbyqxmd.com/read/27908339/vasopressors-and-inotropes-in-sepsis
#6
REVIEW
Leeanne Stratton, David A Berlin, John E Arbo
Vasopressor and inotropes are beneficial in shock states. Norepinephrine is considered the first-line vasopressor for patients with sepsis-associated hypotension. Dobutamine is considered the first-line inotrope in sepsis, and should be considered for patients with evidence of myocardial dysfunction or ongoing signs of hypoperfusion. Vasopressor and inotrope therapy has complex effects that are often difficult to predict; emergency providers should consider the physiology and clinical trial data. It is essential to continually reevaluate the patient to determine if the selected treatment is having the intended result...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27904631/the-effect-of-clinical-supervision-model-on-high-alert-medication-safety-in-intensive-care-units-nurses
#7
Asghar Khalifehzadeh Esfahani, Fatemeh Ramezany Varzaneh, Tahereh Changiz
BACKGROUND: Medication errors and adverse drug events of high alert medication are one of the major problems in therapeutic system. The purpose of the present study was to investigate ύthe effect of clinical supervision model on high alert medication safety in intensive care units nurses. MATERIALS AND METHODS: This was a quasi-experimental study conducted on 32 nurses of intensive care units. The researcher observed the administration of high alert drugs including heparin, warfarin, norepinephrine, dobutamine, and dopamine by nurses and recorded the scores of the work in preventing medication errors, the work in preventing adverse drug events, and medication safety...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27904102/manifestation-of-latent-left-ventricular-outflow-tract-obstruction-in-the-acute-phase-of-takotsubo-cardiomyopathy
#8
Kazuyuki Ozaki, Takeshi Okubo, Komei Tanaka, Yukio Hosaka, Keiichi Tsuchida, Kazuyoshi Takahashi, Hirotaka Oda, Tohru Minamino
Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27901396/effects-of-dobutamine-hydrochloride-on-cardiovascular-function-in-horses-anesthetized-with-isoflurane-with-or-without-acepromazine-maleate-premedication
#9
Mara F Schier, Anthea L Raisis, Cristy J Secombe, Giselle Hosgood, Gabrielle C Musk, Guy D Lester
OBJECTIVE To determine the effects of acepromazine maleate premedication on cardiovascular function before and after infusion of dobutamine hydrochloride for 30 minutes in isoflurane-anesthetized horses. ANIMALS 6 healthy adult horses. PROCEDURES Each horse was anesthetized once following premedication with acepromazine (0.02 mg/kg, IV) administered 30 minutes prior to anesthetic induction (ACP+ treatment) and once without premedication (ACP- treatment). Anesthesia was induced with IV administration of xylazine hydrochloride (0...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27886191/hemodynamic-and-metabolic-effects-of-a-new-pediatric-dobutamine-formulation-in-hypoxic-newborn-pigs
#10
Victoria E Mielgo, Adolf Valls-I-Soler, Juan M Lopez de Heredia, Heike Rabe, Carmen Rey-Santano
BACKGROUND: The aim of our study was to measure drug-related changes in hemodynamics and oxygen metabolism in response to different doses of an age-appropriate dobutamine formulation in hypoxic pigs. A secondary aim was to validate superior vena cava flow (SVCF) as a marker of cardiac index (CI) for subsequent clinical trials of this formulation in humans. METHODS: Newborn pigs (n=18) were exposed to 2h-hypoxia (10-15% oxygen) followed by reoxygenation (21-30% oxygen 4h)...
November 25, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27885445/limited-ventricular-preload-is-the-main-reason-for-reduced-stress-reserve-after-atrial-baffle-repair
#11
Andreas Eicken, Julia Michel, Alfred Hager, Daniel Tanase, Harald Kaemmerer, Julie Cleuziou, John Hess, Peter Ewert
The atrial baffle repair (ABR) significantly improved the fate of patients with transposition of the great arteries (TGA). However, these patients show impaired exercise tolerance and some present severe decline of systemic ventricular function. Intrinsic myocardial weakness, low heart rate response to exercise and diastolic filling impairment are discussed to be causative. Forty-nine long-term survivors with TGA (median age 23.7 year) after ABR were catheterized with measured oxygen consumption in four conditions (baseline, volume, atrial pacing, dobutamine) and the results were compared to 10 normal controls...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27878406/diagnostic-value-of-layer-specific-global-longitudinal-strain-during-adenosine-stress-in-patients-suspected-of-coronary-artery-disease
#12
June A Ejlersen, Steen H Poulsen, Jesper Mortensen, Ole May
Speckle tracking global longitudinal strain (GLS) from dobutamine stress echocardiography (SE) predicts coronary artery disease (CAD). The diagnostic value of GLS from vasodilator SE and the additional value of layer-specific speckle tracking analysis are unclear. We explored the usefulness of layer-specific GLS and non-layer-specific strain (automated functional imaging, AFI) from adenosine SE. The included 132 patients (67% male, 62.6 (9.0) years), of which 46 (35%) had CAD defined as ≥1 stenosis ≥70% (≥50% in the left main), underwent adenosine SE and invasive coronary angiography...
November 22, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27843430/cirrhotic-cardiomyopathy-another-case-of-a-successful-approach-to-treatment-of-hepatorenal-syndrome
#13
Luis Otávio Mocarzel, Jessica Bicca, Luiza Jarske, Thamires Oliveira, Pedro Lanzieri, Ronaldo Gismondi, Mario Luiz Ribeiro
Hepatorenal syndrome (HRS) is defined as a failure of renal function, potentially reversible, in patients with liver cirrhosis and ascites. Recently, a component of cardiomyopathy associated with HRS was described, but the use of positive inotropic medicine as part of the treatment of the acute phase has not been extensively evaluated. We report a second case in our hospital of a patient with HRS type I without previous heart disease, with secondary hemodynamic decompensation due to liver disease, in which the abnormalities in systolic function by speckle-tracking echocardiography were observed and could be reversed by the use of inotropes...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27836099/-management-of-cardiogenic-shock-results-from-a-survey-in-france-and-belgium
#14
S Champion, N Deye
PURPOSE: Physician survey on cardiogenic shock management; recommendations for the management of patients with cardiogenic shock are based mostly on experts' opinion. METHODS: Overall 1585 emails were sent to "senior" intensive care physicians from France and Belgium from September 2014 to march 2015. Response rate was 10% (157 respondents). Agreement was assessed based on RAND/UCLA methodology. RESULTS: Continuous monitoring of cardiac output, vascular filling, noninvasive ventilation were deemed appropriate...
November 8, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27830409/perioperative-cardiovascular-evaluation-for-orthotopic-liver-transplantation
#15
REVIEW
Robert J Donovan, Calvin Choi, Asghar Ali, Douglas M Heuman, Michael Fuchs, Anthony A Bavry, Ion S Jovin
Patients with advanced liver disease have a high prevalence of cardiovascular risk factors, but many of them are asymptomatic. Cardiovascular risk stratification prior to liver transplant can be done by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computer tomography, and coronary angiography, but there are no clear recommendations regarding what method should be used and who should be screened. Because of this and because of inherent risk profile in this population, the variations in practice are significant...
November 9, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27797722/antitumor-effect-of-dobutamine-on-multiple-myeloma-via-mitogen-activated-protein-kinase%C3%A2-pathway-in-vitro
#16
Bingqian Xie, Zhijian Xu, Guang Yang, Gege Chen, Bo Li, Liangning Hu, Wenqin Xiao, Xi Sun, Minjie Gao, Lu Gao, Xiaosong Wu, Yi Tao, Weiliang Zhu, Jumei Shi
No abstract text is available yet for this article.
December 2016: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/27796503/spontaneous-pulmonary-hematoma-in-a%C3%A2-patient-with-sepsis-treated-with-dual-antiplatelet-therapy
#17
Janko Vlaović, Gorazd Voga
A 72-year-old patient was admitted to the medical intensive care unit due to a right-sided, hospital-acquired pneumonia and septic shock with respiratory failure and deterioration of chronic renal failure. During hospitalization the patient required hemodynamic support with norepinephrine and dobutamine, mechanical ventilation and hemodialysis. The patient suffered a non-ST segment elevation myocardial infarction (NSTEMI) and received dual antiplatelet therapy. After 14 days an acute intrapulmonary infiltrate of unknown origin developed, accompanied by fever and a significant increase of the C‑reactive protein (CRP) level...
October 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27787407/vasodilators-in-septic-shock-resuscitation-a-clinical-perspective
#18
Thiago Domingos Corrêa, Roberto Rabello Filho, Murillo Santucci Cesar Assunção, Eliézer Silva, Alexandre Lima
Microcirculatory abnormalities have been shown to be frequent in patients with septic shock despite "normalization" of systemic hemodynamics. Several studies have explored the impact of vasodilator therapy (prostacyclin, inhaled nitric oxide, topic acetylcholine and nitroglycerin) on microcirculation and tissue perfusion, with contradictory findings.In this narrative review, we briefly present the pathophysiological aspects of microcirculatory dysfunction, and depict the evidence supporting the use of vasodilators and other therapeutic interventions (fluid administration, blood transfusion, vasopressors and dobutamine) aiming to improve the microcirculatory flow in septic shock patients...
October 26, 2016: Shock
https://www.readbyqxmd.com/read/27785582/effects-of-cardiac-output-on-the-initial-distribution-volume-of-glucose-in-the-absence-of-fluid-gain-or-loss-in-pigs
#19
Toshinori Kasai, Eiji Hashiba, Junichi Saito, Kazuyoshi Hirota
: The initial distribution volume of glucose (IDVG) has been reported to be a surrogate marker of cardiac preload. However, the relationship between cardiac output and IDVG is not fully understood. We investigated the effects of cardiac output on IDVG in the absence of fluid gain or loss in pigs. MATERIALS AND METHODS: Thirteen pigs were anesthetized and allocated to either the modified cardiac output group (m-CO group, n = 10) or the control group (control group, n = 3)...
October 26, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27756870/early-goal-directed-therapy-in-severe-sepsis-and-septic-shock-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#20
Yao Lu, Han Zhang, Fang Teng, Wen-Jun Xia, Gui-Xiang Sun, Ai-Qing Wen
INTRODUCTION: The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe sepsis and septic shock. METHODS: We searched electronic databases to identify randomized controlled trials that compared EGDT with usual care or lactate-guided therapy in adults with severe sepsis and septic shock...
October 18, 2016: Journal of Intensive Care Medicine
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