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https://www.readbyqxmd.com/read/28630772/severe-rhabdomyolysis-due-to-presumed-drug-interactions-between-atorvastatin-with-amlodipine-and-ticagrelor
#1
Iouri Banakh, Kavi Haji, Ross Kung, Sachin Gupta, Ravindranath Tiruvoipati
Atorvastatin and ticagrelor combination is a widely accepted therapy for secondary prevention of ischaemic heart disease. However, rhabdomyolysis is a well-known rare side effect of statins which should be considered when treatments are combined with cytochrome P450 3A4 enzyme inhibitors. We report a case of atorvastatin and ticagrelor associated severe rhabdomyolysis that progressed to multiorgan failure requiring renal replacement therapy, inotropes, intubation, and mechanical ventilation. Despite withdrawal of the precipitating cause and the supportive measures including renal replacement therapy, creatinine kinase increased due to ongoing rhabdomyolysis rapidly progressing to upper and lower limbs weakness...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28597998/a-novel-mechanical-mitral-valve-replacement-using-sapien-xt
#2
Megan Koehle, Justin A Strote, Mark Guadagnoli, J Bradley Oldemeyer
PATIENT PRESENTATION: We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. EVALUATION AND MANAGEMENT: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure...
June 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595859/left-atrial-appendage-occlusion-in-patients-with-atrial-fibrillation-and-previous-major-gastrointestinal-bleeding-from-the-amplatzer-cardiac-plug-multicenter-registry
#3
Mathieu Lempereur, Adel Aminian, Xavier Freixa, Sameer Gafoor, Samera Shakir, Heyder Omran, Sergio Berti, Gennaro Santoro, Joelle Kefer, Ulf Landmesser, Jens Erik Nielsen-Kudsk, Ignacio Cruz-Gonzalez, Prapa Kanagaratnam, Fabian Nietlispach, Reda Ibrahim, Horst Sievert, Wolfgang Schillinger, Jai-Wun Park, Steffen Gloekler, Apostolos Tzikas
History of major gastrointestinal (GI) bleeding may represent a frequent clinical indication for left atrial appendage occlusion (LAAO) in patients with non-valvular atrial fibrillation (AF). This study aims to investigate the procedural safety and long-term outcome of patients with previous major GI bleeding (MGIB) who underwent LAAO. Data from the Amplatzer Cardiac Plug multicenter registry on 1,047 patients were analyzed. Patients with previous MGIB as indication for LAAO were compared with patients without previous MGIB...
May 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28590260/ghrelin-and-autophagy
#4
Silvia Ezquerro, Gema Frühbeck, Amaia Rodríguez
PURPOSE OF REVIEW: A compromised autophagy is associated with the onset of obesity, type 2 diabetes, nonalcoholic fatty liver disease, cardiovascular and neurodegenerative diseases. Our aim is to review the potential role of ghrelin, a gut hormone involved in energy homeostasis, in the regulation of autophagy. RECENT FINDINGS: In the recent years, it has been demonstrated that autophagy constitutes an important mechanism by which ghrelin exerts a plethora of central and peripheral actions...
June 3, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28587952/the-effect-of-trimetazidine-treatment-in-patients-with-type-2-diabetes-undergoing-percutaneous-coronary-intervention-for-acute-myocardial-infarction
#5
Runjun Li, Xiuying Tang, Quanmin Jing, Qingsheng Wang, Meihong Yang, Xiaoyu Han, Jiayu Zhao, Xiangyou Yu
PURPOSE: Trimetazidine (TMZ) improves clinical outcomes in patients with chronic heart failure and stable coronary artery disease. No study has yet evaluated the efficacy of TMZ in type 2 diabetes patients with acute myocardial infarction (AMI) undergoing Percutaneous Coronary Intervention (PCI). We performed this study to evaluate the efficacy TMZ in DM patients with AMI undergoing PCI, such as the effect on reductions in myocardial enzyme, improvements in liver function, modulation of glucose levels, and improvement in cardiac function...
May 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28572090/gdf15-is-a-heart-derived-hormone-that-regulates-body-growth
#6
Ting Wang, Jian Liu, Caitlin McDonald, Katherine Lupino, Xiandun Zhai, Benjamin J Wilkins, Hakon Hakonarson, Liming Pei
The endocrine system is crucial for maintaining whole-body homeostasis. Little is known regarding endocrine hormones secreted by the heart other than atrial/brain natriuretic peptides discovered over 30 years ago. Here, we identify growth differentiation factor 15 (GDF15) as a heart-derived hormone that regulates body growth. We show that pediatric heart disease induces GDF15 synthesis and secretion by cardiomyocytes. Circulating GDF15 in turn acts on the liver to inhibit growth hormone (GH) signaling and body growth...
June 1, 2017: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/28560717/organ-dysfunction-injury-and-failure-in-acute-heart-failure-from-pathophysiology-to-diagnosis-and-management-a-review-on-behalf-of-the-acute-heart-failure-committee-of-the-heart-failure-association-hfa-of-the-european-society-of-cardiology-esc
#7
REVIEW
Veli-Pekka Harjola, Wilfried Mullens, Marek Banaszewski, Johann Bauersachs, Hans-Peter Brunner-La Rocca, Ovidiu Chioncel, Sean P Collins, Wolfram Doehner, Gerasimos S Filippatos, Andreas J Flammer, Valentin Fuhrmann, Mitja Lainscak, Johan Lassus, Matthieu Legrand, Josep Masip, Christian Mueller, Zoltán Papp, John Parissis, Elke Platz, Alain Rudiger, Frank Ruschitzka, Andreas Schäfer, Petar M Seferovic, Hadi Skouri, Mehmet Birhan Yilmaz, Alexandre Mebazaa
Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality...
May 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28496002/risk-of-cancer-in-patients-with-heart-failure-who-use-digoxin-a-10-year-follow-up-study-and-cell-based-verification
#8
Min-Huey Chung, Yi-Wen Wang, Yung-Lung Chang, Shih-Ming Huang, Wei-Shiang Lin
Heart failure (HF) is the leading cause of death in the world and digoxin remains one of the oldest therapies for HF. However, its safety and efficacy have been controversial since its initial use and there is uncertainty about its long-term efficacy and safety. Recently, the repositioning of cardiac glycosides is to function in anti-tumor activity via multiple working pathways. It is interesting to compare the potential effects of digoxin in clinical patients and cell lines. First, we analyze patient information retrieved from the National Health Insurance Research database of Taiwan between January 1, 2000 and December 31, 2000...
April 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28490545/red-blood-cell-distribution-width-and-myocardial-scar-burden-in-coronary-artery-disease
#9
Caroline Jane Magri, Tan Xiao Tian, Liberato Camilleri, Robert Xuereb, Joseph Galea, Stephen Fava
INTRODUCTION: Red blood cell distribution width (RDW) is a novel independent marker of cardiovascular disease including heart failure, coronary artery disease and myocardial ischaemia. The aim of the study was to investigate a possible relationship between RDW and myocardial scar burden, as assessed by a MIBI viability scan. A secondary objective was to assess whether there is an association between RDW and left ventricular ejection fraction (LVEF). METHODS: The study comprised 123 subjects with ischaemic heart disease who underwent a myocardial viability scan between June 2008 and July 2014...
May 10, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28487868/severe-symptomatic-acute-hyponatremia-in-traumatic-brain-injury-responded-very-rapidly-to-a-single-15-mg-dose-of-oral-tolvaptan-a-mayo-clinic-health-system-hospital-experience-need-for-caution-with-tolvaptan-in-younger-patients-with-preserved-renal-function
#10
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Tolvaptan is now well established as a potent pharmaceutical agent for symptomatic hyponatremia from syndrome of inappropriate antidiuretic hormone secretion (SIADH), congestive heart failure and liver cirrhosis. Previous studies had recruited older (63-65 years) patients with mild renal impairment (serum creatinine, 1.3-1.4 mg/dl). A 2012 report in the Journal of Neurology, Neurosurgery & Psychiatry described tolvaptan as a "lifesaving drug". A major outcome concern in the treatment of chronic hyponatremia is potentially fatal pontine demyelination from over-rapid correction of serum sodium >0...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28465331/renal-resistive-index-reflects-fontan-pathophysiology-and-predicts-mortality
#11
Hideo Ohuchi, Jun Negishi, Yohsuke Hayama, Aya Miyazaki, Isao Shiraishi, Hajime Ichikawa
OBJECTIVES: The renal resistive index (RRI) reflects non-renal pathophysiology, such as great artery stiffness, haemodynamics and even end-organ damage in patients with hypertension. This study was conducted to clarify the clinical significance of the RRI in Fontan pathophysiology. METHODS: We measured the RRI in 280 consecutive Fontan patients and 36 healthy controls. RESULTS: The patients exhibited a higher RRI than the controls (0.71±0...
May 2, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#12
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28456315/usefulness-of-the-direct-and-or-total-bilirubin-to-predict-adverse-outcomes-in-patients-with-acute-decompensated-heart-failure
#13
Atsushi Okada, Yasuo Sugano, Toshiyuki Nagai, Yasuyuki Honda, Naotsugu Iwakami, Hiroki Nakano, Seiji Takashio, Satoshi Honda, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Satoshi Yasuda, Toshihisa Anzai
Abnormal liver function test results are often observed in acute decompensated heart failure (ADHF). However, the prognostic value of bilirubin fractionation has not been elucidated. The prognostic value of direct bilirubin (DB), in comparison with total bilirubin (TB), was examined in 556 consecutive patients with ADHF. Patients with elevated DB showed mostly similar patient characteristics including signs of elevated right-sided pressure (frequent hepatomegaly, jugular venous distention, dilated inferior vena cava, and elevated gamma-glutamyltransferase) and decreased cardiac output (cold extremities, decreased pulse pressure, and lower blood pressure) and other parameters of heart failure (HF) severity (increased plasma renin activity, decreased sodium, total cholesterol, and ejection fraction) to elevated TB; however, only patients with elevated DB showed a significant difference in the frequency of HF history and alkaline phosphatase value...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28451447/dynamic-changes-of-serum-microrna-122-5p-through-therapeutic-courses-indicates-amelioration-of-acute-liver-injury-accompanied-by-acute-cardiac-decompensation
#14
Satoshi Koyama, Takashi Kuragaichi, Yukihito Sato, Yasuhide Kuwabara, Shunsuke Usami, Takahiro Horie, Osamu Baba, Daihiko Hakuno, Yasuhiro Nakashima, Tomohiro Nishino, Masataka Nishiga, Tetsushi Nakao, Hidenori Arai, Takeshi Kimura, Koh Ono
AIMS: Recent studies have shown that serum microRNA (miR) abundance is informative for the diagnosis or prognosis of heart failure. However, the dynamics and kinetics of miRs in acute heart failure are largely unknown. Serial measurement and analysis of serum miRs changes in individuals along their therapeutic course could reduce inter-individual variation and should detect potentially important serum miRs related to disease mechanisms. Based on this concept, we profiled serum miR signatures of blood samples that were obtained sequentially on the day of admission and on hospital Day 7...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28449795/long-term-effect-of-endothelin-receptor-antagonism-with-bosentan-on-the-morbidity-and-mortality-of-patients-with-severe-chronic-heart-failure-primary-results-of-the-enable-trials
#15
Milton Packer, John J V McMurray, Henry Krum, Wolfgang Kiowski, Barry M Massie, Avi Caspi, Craig M Pratt, Mark C Petrie, David DeMets, Isaac Kobrin, Sebastien Roux, Karl Swedberg
OBJECTIVES: The objective of this clinical trial was to evaluate the long-term effect of endothelin receptor antagonism with bosentan on the morbidity and mortality of patients with severe chronic heart failure. BACKGROUND: Endothelin may play a role in heart failure, but short-term clinical trials with endothelin receptor antagonists have reported disappointing results. Long-term trials are lacking. METHODS: In 2 identical double-blind trials, we randomly assigned 1,613 patients with New York Heart Association functional class IIIb to IV heart failure and an ejection fraction <35% to receive placebo or bosentan (target dose 125 mg twice daily) for a median of 1...
May 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28433216/implications-of-alternative-hepatorenal-prognostic-scoring-systems-in-acute-heart-failure-from-dose-ahf-and-rose-ahf
#16
Justin L Grodin, Dianne Gallup, Kevin J Anstrom, G Michael Felker, Horng H Chen, W H Wilson Tang
Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28430919/non-coding-rnas-in-cardiovascular-diseases-diagnostic-and-therapeutic-perspectives
#17
Wolfgang Poller, Stefanie Dimmeler, Stephane Heymans, Tanja Zeller, Jan Haas, Mahir Karakas, David-Manuel Leistner, Philipp Jakob, Shinichi Nakagawa, Stefan Blankenberg, Stefan Engelhardt, Thomas Thum, Christian Weber, Benjamin Meder, Roger Hajjar, Ulf Landmesser
Recent research has demonstrated that the non-coding genome plays a key role in genetic programming and gene regulation during development as well as in health and cardiovascular disease. About 99% of the human genome do not encode proteins, but are transcriptionally active representing a broad spectrum of non-coding RNAs (ncRNAs) with important regulatory and structural functions. Non-coding RNAs have been identified as critical novel regulators of cardiovascular risk factors and cell functions and are thus important candidates to improve diagnostics and prognosis assessment...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430116/ghrelin-expression-and-significance-in-92-patients-with-atrial-fibrillation
#18
Tianyi Ma, Yujiang Su, Shijuan Lu, Moshui Chen, Jianghua Zhong, Zhihong Zhou, Dingjun Sun, Hui Yang, Xue Ao
OBJECTIVE: Ghrelin is a polypeptide that is closely associated with many cardiovascular diseases, such as hypertension, atherosclerosis, and heart failure. This article aims to understand the expression of ghrelin in patients with atrial fibrillation (AF). METHODS: A total of 182 patients with non-valvular heart diseases were recruited, among whom 92 had AF and 90 had sinus arrhythmia (SA). The serum ghrelin amount was tested by the ELASA method. Moreover, blood sugar, lipids, liver function, and renal function were tested...
April 10, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28394435/real-world-clinical-characteristics-and-treatment-patterns-of-individuals-aged-80-and-older-with-nonvalvular-atrial-fibrillation-results-from-the-real-life-multicenter-survey-evaluating-stroke-study
#19
Murat Biteker, Özcan Başaran, Volkan Doğan, İbrahim Altun, Fatma Özpamuk Karadeniz, Ahmet İlker Tekkesin, Yasin Çakıllı, Ceyhan Türkkan, Mehmet Hamidi, Vahit Demir, Mustafa Ozan Gürsoy, Müjgan Tek Öztürk, Gökhan Aksan, Sabri Seyis, Mehmet Ballı, Mehmet Hayri Alıcı, Serdar Bozyel
OBJECTIVES: To compare the clinical characteristics of and use of oral anticoagulant (OAC) therapy in individuals aged 80 and older with atrial fibrillation (AF) with those of individuals younger than 80 with AF in clinical practice. DESIGN: Observational study. SETTING: The ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey trial (NCT02344901), a national observational registry. PARTICIPANTS: Turkish adults with nonvalvular AF (NVAF)...
April 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#20
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
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