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Heart failure management women

Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
Matthew J Kolek, Amy J Graves, Meng Xu, Aihua Bian, Pedro Luis Teixeira, M Benjamin Shoemaker, Babar Parvez, Hua Xu, Susan R Heckbert, Patrick T Ellinor, Emelia J Benjamin, Alvaro Alonso, Joshua C Denny, Karel G M Moons, Ayumi K Shintani, Frank E Harrell, Dan M Roden, Dawood Darbar
Importance: Atrial fibrillation (AF) contributes to substantial morbidity, mortality, and health care expenditures. Accurate prediction of incident AF would enhance AF management and potentially improve patient outcomes. Objective: To validate the AF risk prediction model originally developed by the Cohorts for Heart and Aging Research in Genomic Epidemiology-Atrial Fibrillation (CHARGE-AF) investigators using a large repository of electronic medical records (EMRs)...
October 12, 2016: JAMA Cardiology
Katarzyna Rygiel
Advances in oncologic therapies have allowed many patients with breast cancer to achieve better outcomes and longer survival. However, this progress has been tempered by cardiotoxicity, associated with anticancer therapies, ranging from subclinical abnormalities to irreversible life-threatening complications, such as congestive heart failure or cardiomyopathy. In particular, exposure to chemotherapy (CHT), including anthracyclines and trastuzumab, can lead to cardiac dysfunction with short- or long-term consequences, among patients with breast cancer...
September 2016: Indian Journal of Pharmacology
Ioannis Vogiatzis, Irena Dapcevic, Antonis Datsios, Kostas Koutsambasopoulos, Argirios Gontopoulos, Savas Grigoriadis
INTRODUCTION: The propeptide of brain natriuretic peptide (ProBNP) is used for the diagnosis of left ventricle dysfunction and heart failure. In patients with an Acute Coronary Syndrome (ACS) it can contribute to both short and long term prognosis of cardiovascular events that could be very important for management and therapy of these patients. AIM: The aim of this study was to evaluate the prognostic value of ProBNP for the clinical course after an acute coronary syndrome, compared with that of cardiac troponine T (cTnT) and the risk stratification of patients with acute coronary syndrome, both during hospitalization and six months later...
July 27, 2016: Medical Archives
Sarah Tsiaras, Athena Poppas
Young women may have asymptomatic mitral valve disease which becomes unmasked during the haemodynamic stress of pregnancy. Rheumatic mitral stenosis is the most common cardiac disease found in women during pregnancy. The typical increased volume and heart rate of pregnancy are not well tolerated in patients with more than mild stenosis. Maternal complications of atrial fibrillation and congestive heart failure can occur, and are increased in patients with poor functional class and severe pulmonary artery hypertension...
March 2009: Obstetric Medicine
Lalitha Sundararaman, Jennifer Hochman Cohn, J Sudharma Ranasinghe
Maternal complete heart block can pose significant challenges for the anesthesiologist in the antepartum, peripartum, and postpartum periods. Some patients may present for the first time in the puerperium with dizziness, weakness, syncope, or congestive heart failure as a result of the additional hemodynamic burden that accompanies pregnancy. Although there is an increase in permanent pacemaker placement in young symptomatic patients before pregnancy, prophylactic placement of pacemakers in asymptomatic parturients is not always indicated...
September 2016: Journal of Clinical Anesthesia
Anne S Ersbøll, Peter Damm, Finn Gustafsson, Niels G Vejlstrup, Marianne Johansen
Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal disease defined by heart failure towards the end of pregnancy or in the months following delivery. We aim to raise awareness of the condition and give the clinician an overview of current knowledge on the mechanisms of pathophysiology, diagnostics and clinical management MATERIAL AND METHODS: Systematic literature searches were performed in PubMed and Embase up to June 2016. Cohorts of more than 20 women with PPCM conducted after 2000 were selected to report contemporary outcomes and prognostic data...
August 22, 2016: Acta Obstetricia et Gynecologica Scandinavica
Magalie Ladouceur, Louise Benoit, Jelena Radojevic, Adeline Basquin, Claire Dauphin, Sébastien Hascoet, Pamela Moceri, Charlene Bredy, Laurence Iserin, Marielle Gouton, Jacky Nizard
OBJECTIVE: There is growing evidence that maternal mortality in pregnant women with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is lower than that in available data. In order to evaluate this hypothesis, we collected data of pregnancies in women with PAH-CHD. METHODS: Women with PAH-CHD followed in seven French referral centres were retrospectively included from 1997 to 2015. All pregnancies were recorded. We collected data on maternal, obstetrical and neonatal outcomes...
August 10, 2016: Heart: Official Journal of the British Cardiac Society
Eileen M Czerwinski
Peripartum/postpartum cardiomyopathy (PPCM) is a rare condition associated with pregnancy in which there is left ventricular (LV) dysfunction resulting in symptoms of heart failure (). This occurs in previously healthy women and is seen in the last month of pregnancy or during the first 5 months postpartum (). Incidence ranges from 1 in 1,300 to 1 in 15,000 pregnancies in the United States (). A case study is presented of a patient with severe impairment of LV function seen in the emergency department (ED)...
July 2016: Advanced Emergency Nursing Journal
Benjamin Laliberte, Brent N Reed, Ayesha Ather, Sandeep Devabhakthuni, Kristin Watson, Allison B Lardieri, Carissa M Baker-Smith
Peripartum cardiomyopathy (PPCM) is an uncommon, idiopathic complication of pregnancy associated with significant (10-30%) mortality. The disease occurs late in pregnancy or in the months following delivery, resulting in reduced systolic function and heart failure (HF) symptoms. Limited direction is provided for the management of PPCM, and the safe and effective use of medications in pregnant and breastfeeding women with PPCM presents a unique challenge. Although several HF therapies in pregnant and lactating women are supported by robust evidence, evidence to support the use of other therapies is significantly lacking...
September 2016: Pharmacotherapy
Paul Sorajja, Wesley A Pedersen, Richard Bae, John R Lesser, Desmond Jay, David Lin, Kevin Harris, Barry J Maron
BACKGROUND: Few therapeutic options exist for patients with severe heart failure due to obstructive hypertrophic cardiomyopathy (HCM) who are at unacceptable surgical risk. We hypothesized that percutaneous plication of the mitral valve could reduce left ventricular outflow tract (LVOT) obstruction and associated mitral regurgitation, thereby leading to amelioration of heart failure symptoms. OBJECTIVES: This study sought to evaluate the potential effectiveness of percutaneous mitral valve plication as a therapy for patients with symptomatic, obstructive HCM...
June 21, 2016: Journal of the American College of Cardiology
Ram Prakash Narayanan, Sabnam Samad
One in 250 pregnancies in the UK involves diabetes. The majority of cases (87.5%) are gestational diabetes, 7.5% are type 1 and 5% are type 2 diabetes. Diabetes in pregnancy is associated with a five fold increase in risk of stillbirth and a two-fold increased risk of congenital defects compared with the general maternity population. Fasting blood glucose levels above 5.3 mmol/L can directly affect organogenesis, particularly of the fetal heart and spine. Hyperglycaemia can cause placental failure and stillbirth and for this reason early delivery is recommended...
May 2015: Practitioner
Sadeer G Al-Kindi, Chantal ElAmm, Mahazarin Ginwalla, Emile Mehanna, Michael Zacharias, Rodolfo Benatti, Guilherme H Oliveira, Chris T Longenecker
BACKGROUND: Persons living with HIV are at a higher risk of cardiovascular disease despite effective antiretroviral therapy and dramatic reductions in AIDS-related conditions. We sought to identify the epidemiology of heart failure (HF) among persons living with HIV in the United States in an era of contemporary antiretroviral therapy. METHODS: Explorys is an electronic healthcare database that aggregates medical records from 23 healthcare systems nationwide. Using systemized nomenclature of medicine-clinical terms (SNOMED-CT), we identified adult patients (age>18), who had active records over the past year (September 2014-September 2015)...
September 1, 2016: International Journal of Cardiology
Francisco C Villafuerte, Noemí Corante
Villafuerte, Francisco C., and Noemí Corante. Chronic mountain sickness: clinical aspects, etiology, management, and treatment. High Alt Med Biol. 17:61-69, 2016.-Millions of people worldwide live at a high altitude, and a significant number are at risk of developing Chronic Mountain Sickness (CMS), a progressive incapacitating syndrome caused by lifelong exposure to hypoxia. CMS is characterized by severe symptomatic excessive erythrocytosis (EE; Hb ≥19 g/dL for women and Hb ≥21 g/dL for men) and accentuated hypoxemia, which are frequently associated with pulmonary hypertension...
June 2016: High Altitude Medicine & Biology
George W Weyer, Beth Dunlap, Sachin D Shah
Hypertension is the most commonly encountered chronic medical condition in primary care and one of the most significant modifiable cardiovascular risk factors for women and men. Timely diagnosis and evidence-based management offer an important opportunity to reduce the risk of hypertension-related morbidity and mortality, including cardiovascular events, end-stage renal disease, and heart failure. Clinical trials have shown significant improvements in patient-oriented outcomes when hypertension is well-controlled, yet many hypertensive patients remain undiagnosed, uncontrolled, or managed with inappropriate pharmacotherapy...
June 2016: Obstetrics and Gynecology Clinics of North America
Anahita Dua, Michael Romanelli, Gilbert R Upchurch, James Pan, Douglas Hood, Kim J Hodgson, Sapan S Desai
BACKGROUND: A variety of patient factors are known to adversely impact outcomes after carotid endarterectomy (CEA) or carotid artery stenting (CAS). However, their specific impact on complications and mortality and how they differ between CEA and CAS is unknown. The purpose of this study is to identify patient and hospital factors that adversely impact outcomes. METHODS: Patients who underwent CEA or CAS between 1998 and 2012 (N = 1,756,445) were identified using the Agency for Healthcare Research and Quality National Inpatient Sample and State Ambulatory Services Databases...
September 2016: Journal of Vascular Surgery
Lara Dhingra, Nathan F Dieckmann, Helena Knotkova, Jack Chen, Alexa Riggs, Brenda Breuer, Barbara Hiney, Bernard Lee, Maureen McCarthy, Russell Portenoy
CONTEXT: Community-based palliative care may support seriously ill homebound patients. Programs vary widely, and few studies have described the heterogeneity of the populations served or service delivery models. OBJECTIVES: To evaluate a diverse population served by an interdisciplinary model of community-based specialist palliative care and the variation in service delivery over time and identify subgroups with distinct illness burden profiles. METHODS: A retrospective cohort study evaluated longitudinal electronic health record data from 894 patients served during 2010-2013...
August 2016: Journal of Pain and Symptom Management
Hyder O Mirghani, Mohammed A Elnour, Akasha M Taha, Abdulateef S Elbadawi
BACKGROUND: Gender differences among patients with the acute coronary syndrome is still being debated, no research has been done on gender inequality among coronary syndrome patients in Sudan. OBJECTIVES: To study gender differences in presentation, management, and outcomes of acute coronary syndrome in Sudan. SUBJECTS AND METHODS: This cross-sectional descriptive longitudinal study was conducted in Omdurman Teaching Hospital between July 2014 and August 2015...
May 2016: Journal of Family & Community Medicine
N Ali-Tatar Chentir, Y Tir, L Ouabdesselam, M-T Chentir
OBJECTIVE: To assess the left ventricular (LV) filling pressures by Doppler Tissulaire Imaging (DTI) in the management of hypertensive patients with heart failure and preserved systolic function (HF-PEF) in our outpatient clinic. To involve the patient on the basis of their clinical, biological and echocardiography data, in identifying the risk factors that need change. PATIENTS AND METHODS: From 2004 to 2014, heart failure with preserved systolic function (HF-PEF) has been diagnosed in 200 consecutive hypertensive patients (pts) at our Algerian outpatient unit...
June 2016: Annales de Cardiologie et D'angéiologie
Robert Carroll, Alison Mudge, Jessica Suna, Charles Denaro, John Atherton
BACKGROUND: Heart failure (HF) medications improve clinical outcomes, with optimal doses defined in clinical trials. Patient, provider and system barriers may limit achievement of optimal doses in real life settings, although disease management programs (HF-DMPs) can facilitate up-titration. METHODS AND RESULTS: Secondary analysis of a prospective cohort of 216 participants recently hospitalized with systolic HF, attending 5 HF-DMPs in Queensland, Australia. Medication history at baseline (6weeks after discharge) and 6months provided data to describe prescription rates, dosage and optimal titration of HF medications, and associations with patient and system factors were explored...
August 1, 2016: International Journal of Cardiology
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