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Cardiac precision medicine

Nureddin Ashammakhi, Outi Kaarela, Patrizia Ferretti
Much has already been done to achieve precisely controlled and customised regenerative therapies. Thanks to recent advances made in several areas relevant to regenerative medicine including the use of stimuli-responsive materials, 4-dimensional biofabrication, inducible pluripotent stem cells, control of stem cell fate using chemical and physical factors, minimal access delivery, and information-communication technology. In this short perspective, recent advances are discussed with a focus on a recent report on the use of mechanical stretching of nanoparticle-laden stem cells by using external magnetic field to induce defined cardiac line differentiation...
February 26, 2018: Journal of Craniofacial Surgery
Elif Hande Ozcan Cetin, Ozcan Ozeke, Erdogan Ilkay, Dursun Aras, Serkan Topaloglu, Zehra Golbasi, Sinan Aydogdu, Can Ozer
Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease such as atherosclerosis or cancer. Some authors speculated that atherosclerotic coronary artery disease (CAD) could be considered a "cancer of the coronary arterial wall". Although the percutaneous coronary intervention (PCI) has proven to be effective in decreasing mortality rates among patients with acute coronary syndromes, the previous meta-analyses of PCI versus optimal medical therapy for stable CAD have not been able to demonstrate a reduction in major adverse cardiac outcomes...
January 2018: Indian Heart Journal
Zhan Wang, Sang Jin Lee, Heng-Jie Cheng, James J Yoo, Anthony Atala
Bioengineering of a functional cardiac tissue composed of primary cardiomyocytes has great potential for myocardial regeneration and in vitro tissue modeling. However, its applications remain limited because the cardiac tissue is a highly organized structure with unique physiologic, biomechanical, and electrical properties. In this study, we undertook a proof-of-concept study to develop a contractile cardiac tissue with cellular organization, uniformity, and scalability by using three-dimensional (3D) bioprinting strategy...
February 13, 2018: Acta Biomaterialia
Miklos D Kertai, Andrew D Shaw
No abstract text is available yet for this article.
February 8, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
James E Andruchow, Peter A Kavsak, Andrew D McRae
This article synthesizes current best evidence for the evaluation of patients with suspected acute coronary syndrome (ACS) using high-sensitivity troponin assays, enabling physicians to effectively incorporate them into practice. Unlike conventional assays, high-sensitivity assays can precisely measure blood cardiac troponin concentrations in the vast majority of healthy individuals, facilitating the creation of rapid diagnostic algorithms. Very low troponin concentrations on presentation accurately rule out acute myocardial infarction (AMI) and enable the discharge of approximately 20% of patients after a single test, whereas an additional 30%-40% of patients can be safely discharged after short-interval serial sampling in as little as 1 or 2 hours...
February 2018: Canadian Journal of Cardiology
Xiaochuan Dai, Guosong Hong, Teng Gao, Charles M Lieber
Nanobioelectronics represents a rapidly developing field with broad-ranging opportunities in fundamental biological sciences, biotechnology, and medicine. Despite this potential, seamless integration of electronics has been difficult due to fundamental mismatches, including size and mechanical properties, between the elements of the electronic and living biological systems. In this Account, we discuss the concept, development, key demonstrations, and future opportunities of mesh nanoelectronics as a general paradigm for seamless integration of electronics within synthetic tissues and live animals...
January 30, 2018: Accounts of Chemical Research
Angela Adler, Pia Kirchmeier, Julian Reinhard, Barbara Brauner, Irmtraud Dunger, Gisela Fobo, Goar Frishman, Corinna Montrone, H-Werner Mewes, Matthias Arnold, Andreas Ruepp
BACKGROUND: Thoroughly annotated data resources are a key requirement in phenotype dependent analysis and diagnosis of diseases in the area of precision medicine. Recent work has shown that curation and systematic annotation of human phenome data can significantly improve the quality and selectivity for the interpretation of inherited diseases. We have therefore developed PhenoDis, a comprehensive, manually annotated database providing symptomatic, genetic and imprinting information about rare cardiac diseases...
January 25, 2018: Orphanet Journal of Rare Diseases
Thomas Caskey
Precision medicine was conceptualized on the strength of genomic sequence analysis. High-throughput functional metrics have enhanced sequence interpretation and clinical precision. These technologies include metabolomics, magnetic resonance imaging, and I rhythm (cardiac monitoring), among others. These technologies are discussed and placed in clinical context for the medical specialties of internal medicine, pediatrics, obstetrics, and gynecology. Publications in these fields support the concept of a higher level of precision in identifying disease risk...
December 20, 2017: Annual Review of Medicine
Phillip S Cuculich, Matthew R Schill, Rojano Kashani, Sasa Mutic, Adam Lang, Daniel Cooper, Mitchell Faddis, Marye Gleva, Amit Noheria, Timothy W Smith, Dennis Hallahan, Yoram Rudy, Clifford G Robinson
BACKGROUND: Recent advances have enabled noninvasive mapping of cardiac arrhythmias with electrocardiographic imaging and noninvasive delivery of precise ablative radiation with stereotactic body radiation therapy (SBRT). We combined these techniques to perform catheter-free, electrophysiology-guided, noninvasive cardiac radioablation for ventricular tachycardia. METHODS: We targeted arrhythmogenic scar regions by combining anatomical imaging with noninvasive electrocardiographic imaging during ventricular tachycardia that was induced by means of an implantable cardioverter-defibrillator (ICD)...
December 14, 2017: New England Journal of Medicine
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
Tanya M Rossi, Peter A Kavsak, M Grant Maxie, David L Pearl, W Glen Pyle, Peter W Physick-Sheard
Human cardiac troponin I (cTnI) assays have been used in equine medicine, often without prior analytical validation for equine use. In the absence of appropriate validation, the clinical significance of assay results is uncertain and can lead to misdiagnosis. We followed the American Society for Veterinary Clinical Pathology guidelines and investigated linearity, precision, limit of quantification (LoQ), and comparative recovery for 6 commercial cTnI assays developed for use in human medicine. Clinically acceptable linearity was observed in assays A-D, whereas assay E did not detect equine cTnI in any sample...
March 2018: Journal of Veterinary Diagnostic Investigation
Joseph A Ladapo, Matthew J Budoff, David Sharp, Jane Z Kuo, Lin Huang, Bruce Maniet, Lee Herman, Mark Monane
BACKGROUND: Diagnosing obstructive coronary artery disease (CAD) is challenging in elderly adults, and current diagnostic approaches for CAD expose these individuals to risks from contrast dye and invasive procedures. DESIGN: A Registry to Evaluate Patterns of Care Associated with the Use of Corus CAD in Real World Clinical Care Settings (PRESET; NCT01677156), pragmatic clinical trial. SETTING: Community, 21 primary care practices. PARTICIPANTS: Of 566 stable, nonacute outpatients presenting with symptoms suggestive of obstructive CAD, the 176 who were aged 65 and older (median age 70, 61% female) were the current study participants...
February 2018: Journal of the American Geriatrics Society
Solenne Paiva, Onnik Agbulut
At present, cardiovascular diseases are depicted to be the leading cause of death worldwide according to the World Health Organization. In the future, projections predict that ischemic heart disease will persist in the top main causes of illness. Within this alarming context, some tiny master regulators of gene expression programs, namely, microRNAs (miRNAs) carry three promising potentials. In fact, miRNAs can prove to be useful not only in terms of biomarkers allowing heart injury detection but also in terms of therapeutics to overcome limitations of past strategies and treat the lesions...
2017: Frontiers in Cardiovascular Medicine
Mohamed Asik Rajmohamed, Suganthy Natarajan, Premkumar Palanisamy, Akbarsha Mohammad Abdulkader, Archunan Govindaraju
Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder clinically characterized by memory loss and impaired cognitive function. Cholinergic enzyme deficiency and oxidative stress are the two major factors implicated in the pathogenesis of AD. The symptomatic treatment, as of now, is the use of cholinesterase inhibitors toward cholinergic "downturn." Therefore, there is a search for compounds that will be useful in focused therapies. There has been suggestion that Terminalia chebula fruit would be a potential source...
October 2017: Pharmacognosy Magazine
Kathleen T Hickey
PURPOSE: The purpose of this article is to provide an overview of strategies to build and sustain a career as a nurse scientist. This article examines how to integrate technologies and precision approaches into clinical practice, research, and education of the next generation of nursing scholars. DESIGN: This article presents information for shaping a sustainable transdisciplinary career. Programs of research that utilize self-management to improve quality of life are discussed throughout the article...
January 2018: Journal of Nursing Scholarship
(no author information available yet)
Bahous MC, Shadmi E. Health information exchange and information gaps in referrals to a pediatric emergency department. Int J Med Inform 2016;87:68-74 Esmaeilzadeh P, Sambasivan M. Health Information Exchange (HIE): A literature review, assimilation pattern and a proposed classification for a new policy approach. J Biomed Inform 2016;64:74-86 Massoudi BL, Marcial LH, Tant E, Adler-Milstein J, West SL...
August 2017: Yearbook of Medical Informatics
Michael E Nassif, Yuanyuan Tang, John G Cleland, William T Abraham, Cecilia Linde, Michael R Gold, James B Young, J Claude Daubert, Lou Sherfesee, Dan Schaber, Anthony S L Tang, Philip G Jones, Suzanne V Arnold, John A Spertus
BACKGROUND: Clinical trials have established the average benefit of cardiac resynchronization therapy (CRT), but estimating benefit for individual patients remains difficult because of the heterogeneity in treatment response. Accordingly, we created a multivariable model to predict changes in quality of life (QoL) with and without CRT. METHODS AND RESULTS: Patient-level data from 5 randomized trials comparing CRT with no CRT were used to create a prediction model of change in QoL at 3 months using a partial proportional odds model for no change, small, moderate, and large improvement, or deterioration of any magnitude...
October 2017: Circulation. Heart Failure
Iain R Crossingham, Daniel R Nethercott, Malachy O Columb
BACKGROUND: Measuring cardiac output is common in critical care and perioperative medicine. Different monitoring systems are often judged against others in comparative studies. There is no agreed standard or definition on which to base the conclusions of such studies. OBJECTIVES: To review comparative studies of cardiac output monitors using an agreement:tolerability index (ATI) as a measure of monitor precision. To compare the ATI of a monitor with the conclusions of authors regarding agreement and clinical utility...
November 2016: Journal of the Intensive Care Society
Freddy Odille, Aurélien Bustin, Shufang Liu, Bailiang Chen, Pierre-André Vuissoz, Jacques Felblinger, Laurent Bonnemains
PURPOSE: Segmentation of cardiac cine MRI data is routinely used for the volumetric analysis of cardiac function. Conventionally, 2D contours are drawn on short-axis (SAX) image stacks with relatively thick slices (typically 8 mm). Here, an acquisition/reconstruction strategy is used for obtaining isotropic 3D cine datasets; reformatted slices are then used to optimize the manual segmentation workflow. METHODS: Isotropic 3D cine datasets were obtained from multiple 2D cine stacks (acquired during free-breathing in SAX and long-axis (LAX) orientations) using nonrigid motion correction (cine-GRICS method) and super-resolution...
October 2, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Barry H Trachtenberg, Joshua M Hare
Inflammatory activation occurs in nearly all forms of myocardial injury. In contrast, inflammatory cardiomyopathies refer to a diverse group of disorders in which inflammation of the heart (or myocarditis) is the proximate cause of myocardial dysfunction, causing injury that can range from a fully recoverable syndrome to one that leads to chronic remodeling and dilated cardiomyopathy. The most common cause of inflammatory cardiomyopathies in developed countries is lymphocytic myocarditis most commonly caused by a viral pathogenesis...
September 15, 2017: Circulation Research
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