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Cardiac precision medicine

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https://www.readbyqxmd.com/read/29261360/precision-medicine-functional-advancements
#1
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
https://www.readbyqxmd.com/read/29236642/noninvasive-cardiac-radiation-for-ablation-of-ventricular-tachycardia
#2
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
https://www.readbyqxmd.com/read/29230392/non-invasive-monitoring-of-cardiac-output-in-critical-care-medicine
#3
REVIEW
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
https://www.readbyqxmd.com/read/29224512/analytical-validation-of-cardiac-troponin-i-assays-in-horses
#4
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...
December 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/29210056/utility-of-a-precision-medicine-test-in-elderly-adults-with-symptoms-suggestive-of-coronary-artery-disease
#5
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...
December 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29209617/mirroring-the-multiple-potentials-of-micrornas-in-acute-myocardial-infarction
#6
REVIEW
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
https://www.readbyqxmd.com/read/29142396/antioxidant-and-cholinesterase-inhibitory-activities-of-ethyl-acetate-extract-of-terminalia-chebula-cell-free-in-vitro-and-in-silico-studies
#7
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
https://www.readbyqxmd.com/read/29135066/developing-and-sustaining-a-career-as-a-transdisciplinary-nurse-scientist
#8
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...
November 14, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/29063541/best-paper-selection
#9
(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 https://linkinghub.elsevier.com/retrieve/pii/S1386-5056(15)30078-2 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 http://www.sciencedirect.com/science/article/pii/S1532046416301241?via%3Dihub Massoudi BL, Marcial LH, Tant E, Adler-Milstein J, West SL...
August 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29038172/precision-medicine-for-cardiac-resynchronization-predicting-quality-of-life-benefits-for-individual-patients-an-analysis-from-5-clinical-trials
#10
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
https://www.readbyqxmd.com/read/28979515/comparing-cardiac-output-monitors-and-defining-agreement-a-systematic-review-and-meta-analysis
#11
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
https://www.readbyqxmd.com/read/28971520/isotropic-3d-cardiac-cine-mri-allows-efficient-sparse-segmentation-strategies-based-on-3d-surface-reconstruction
#12
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
https://www.readbyqxmd.com/read/28912184/inflammatory-cardiomyopathic-syndromes
#13
REVIEW
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
https://www.readbyqxmd.com/read/28889247/guidelines-for-autopsy-investigation-of-sudden-cardiac-death-2017-update-from-the-association-for-european-cardiovascular-pathology
#14
Cristina Basso, Beatriz Aguilera, Jytte Banner, Stephan Cohle, Giulia d'Amati, Rosa Henriques de Gouveia, Cira di Gioia, Aurelie Fabre, Patrick J Gallagher, Ornella Leone, Joaquin Lucena, Lubov Mitrofanova, Pilar Molina, Sarah Parsons, Stefania Rizzo, Mary N Sheppard, Maria Paz Suárez Mier, S Kim Suvarna, Gaetano Thiene, Allard van der Wal, Aryan Vink, Katarzyna Michaud
Although sudden cardiac death (SCD) is one of the most important modes of death in Western countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate diagnosis of the causes of SCD is now of particular importance. Pathologists are responsible for determining the precise cause and mechanism of sudden death but there is still considerable variation in the way in which they approach this increasingly complex task...
September 9, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28874934/emergency-physician-performed-transesophageal-echocardiography-in-simulated-cardiac-arrest
#15
Don V Byars, Jordan Tozer, John M Joyce, Michael J Vitto, Lindsay Taylor, Turan Kayagil, Matt Jones, Matthew Bishop, Barry Knapp, David Evans
INTRODUCTION: Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874244/the-interplay-between-fasting-glucose-echocardiography-and-biomarkers-pathophysiological-considerations-and-prognostic-implications
#16
Manan Pareek
BACKGROUND: Traditional cardiovascular risk stratification tools that employ clinical risk factors are limited by their modest discriminative abilities. As such, robust cardiovascular risk assessment, including our understanding of the complex interplay between risk factors, in the primary preventive setting, remains incomplete. Phenotypical heterogeneity may be even greater among subjects with hyperglycemic conditions, i.e., prediabetes and diabetes, which is worrisome, given the dramatic global rise in mean fasting glucose levels, and the strong association with adverse cardiovascular outcomes...
September 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28867116/precision-medicine-and-pet-computed-tomography-in-cardiovascular-disorders
#17
REVIEW
Elizabeth H Dibble, Don C Yoo
PET/computed tomography (CT) can evaluate the metabolic and anatomic involvement of a variety of inflammatory, infectious, and malignant cardiovascular disorders. PET/CT is useful in evaluating coronary vasculature, hibernating myocardium, cardiac sarcoidosis, cardiac amyloidosis, cerebrovascular disease, acute aortic syndromes, cardiac and vascular neoplasms, cardiac and vascular infections, and vasculitis. Novel targeted radiopharmaceutical agents and novel use of established techniques show promise in diagnosing and monitoring cardiovascular diseases...
October 2017: PET Clinics
https://www.readbyqxmd.com/read/28856778/temporally-resolved-parametric-assessment-of-z-magnetization-recovery-topaz-dynamic-myocardial-t1-mapping-using-a-cine-steady-state-look-locker-approach
#18
Sebastian Weingärtner, Chetan Shenoy, Benedikt Rieger, Lothar R Schad, Jeanette Schulz-Menger, Mehmet Akçakaya
PURPOSE: To develop and evaluate a cardiac phase-resolved myocardial T1 mapping sequence. METHODS: The proposed method for temporally resolved parametric assessment of Z-magnetization recovery (TOPAZ) is based on contiguous fast low-angle shot imaging readout after magnetization inversion from the pulsed steady state. Thereby, segmented k-space data are acquired over multiple heartbeats, before reaching steady state. This results in sampling of the inversion-recovery curve for each heart phase at multiple points separated by an R-R interval...
August 30, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28740468/evolution-of-precision-medicine-and-surgical-strategies-for-bicuspid-aortic-valve-associated-aortopathy
#19
Ali Fatehi Hassanabad, Alex J Barker, David Guzzardi, Michael Markl, Chris Malaisrie, Patrick M McCarthy, Paul W M Fedak
Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1-2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and associated with catastrophic clinical events, such as aortic dissection and rupture. Therefore, frequent monitoring and early intervention with prophylactic surgical resection of the proximal aorta is often recommended...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28736756/advancing-the-science-of-myocardial-recovery-with-mechanical-circulatory-support-a-working-group-of-the-national-heart-lung-and-blood-institute
#20
Stavros G Drakos, Francis D Pagani, Martha S Lundberg, J Timothy Baldwin
The medical burden of heart failure (HF) has spurred interest in clinicians and scientists to develop therapies to restore the function of a failing heart. To advance this agenda, the National Heart Lung Blood Institute (NHLBI) convened a Working Group of experts on June 2-3, 2016 in Bethesda Maryland to develop recommendations for the NHLBI aimed at advancing the science of cardiac recovery in the setting of mechanical circulatory support (MCS). MSC devices effectively reduce volume and pressure overload that drives the cycle of progressive myocardial dysfunction, thereby triggering structural and functional reverse remodeling...
June 2017: JACC. Basic to Translational Science
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