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Cardiac precision medicine

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https://www.readbyqxmd.com/read/29736398/educational-software-applied-in-teaching-electrocardiogram-a-systematic-review
#1
REVIEW
Paulo A I Pontes, Rafael O Chaves, Roberto C Castro, Érica F de Souza, Marcos C R Seruffo, Carlos R L Francês
Background: The electrocardiogram (ECG) is the most used diagnostic tool in medicine; in this sense, it is essential that medical undergraduates learn how to interpret it correctly while they are still on training. Naturally, they go through classic learning (e.g., lectures and speeches). However, they are not often efficiently trained in analyzing ECG results. In this regard, methodologies such as other educational support tools in medical practice, such as educational software, should be considered a valuable approach for medical training purposes...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29731778/genome-editing-redefines-precision-medicine-in-the-cardiovascular-field
#2
REVIEW
Elda Dzilic, Harald Lahm, Martina Dreßen, Marcus-André Deutsch, Rüdiger Lange, Sean M Wu, Markus Krane, Stefanie A Doppler
Genome editing is a powerful tool to study the function of specific genes and proteins important for development or disease. Recent technologies, especially CRISPR/Cas9 which is characterized by convenient handling and high precision, revolutionized the field of genome editing. Such tools have enormous potential for basic science as well as for regenerative medicine. Nevertheless, there are still several hurdles that have to be overcome, but patient-tailored therapies, termed precision medicine, seem to be within reach...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29728395/-scn5a-na-v-1-5-variant-functional-perturbation-and-clinical-presentation-variants-of-a-certain-significance
#3
Brett M Kroncke, Andrew M Glazer, Derek K Smith, Jeffrey D Blume, Dan M Roden
BACKGROUND: Accurately predicting the impact of rare nonsynonymous variants on disease risk is an important goal in precision medicine. Variants in the cardiac sodium channel SCN5A (protein NaV 1.5; voltage-dependent cardiac Na+ channel) are associated with multiple arrhythmia disorders, including Brugada syndrome and long QT syndrome. Rare SCN5A variants also occur in ≈1% of unaffected individuals. We hypothesized that in vitro electrophysiological functional parameters explain a statistically significant portion of the variability in disease penetrance...
May 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29700394/stage-specific-effects-of-bioactive-lipids-on-human-ipsc-cardiac-differentiation-and-cardiomyocyte-proliferation
#4
Arun Sharma, Yuan Zhang, Jan W Buikema, Vahid Serpooshan, Orlando Chirikian, Nina Kosaric, Jared M Churko, Elda Dzilic, Alice Shieh, Paul W Burridge, Joseph C Wu, Sean M Wu
Bioactive lipids such as sphingosine-1-phosphate (S1P) and lysophosphatidic acid (LPA) regulate diverse processes including cell proliferation, differentiation, and migration. However, their roles in cardiac differentiation and cardiomyocyte proliferation have not been explored. Using a 96-well differentiation platform for generating human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) we found that S1P and LPA can independently enhance cardiomyocyte generation when administered at an early stage of differentiation...
April 26, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29692203/a-new-generalized-cycle-ergometry-equation-for-predicting-maximal-oxygen-uptake-the-fitness-registry-and-the-importance-of-exercise-national-database-friend
#5
Peter Kokkinos, Leonard A Kaminsky, Ross Arena, Jiajia Zhang, Jonathan Myers
Background To develop a clinically applicable equation derived from direct assessment of maximal oxygen uptake (VO2max ) to predict VO2max assessed indirectly during cycle ergometry. Design VO2max was assessed by open-circuit spirometry during a graded maximal exercise test using cycle ergometry. Multivariable linear regression analysis was applied to identify the most relevant variables and construct the best prediction model for VO2max using a random sample of 70% from each of the following age categories: <40, 40-50, 50-70 and >70 years; the remaining 30% was used for validation...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29570167/advanced-morphologic-analysis-for-diagnosing-allograft-rejection-the-case-of-cardiac-transplant-rejection
#6
Eliot G Peyster, Anant Madabhushi, Kenneth B Margulies
Allograft rejection remains a significant concern following all solid organ transplants. While qualitative morphologic analysis with histologic grading of biopsy samples is the main tool employed, for diagnosing allograft rejection, this standard has significant limitations in precision and accuracy that affect patient care. The use of endomyocardial biopsy (EMB) to diagnose cardiac allograft rejection (CAR) illustrates the significant shortcomings of current approaches for diagnosing allograft rejection. Despite disappointing interobserver variability, concerns about discordance with clinical trajectories, attempts at revising the histologic criteria and efforts to establish new diagnostic tools with imaging and gene expression profiling, no method has yet supplanted EMB as the diagnostic gold standard...
March 22, 2018: Transplantation
https://www.readbyqxmd.com/read/29564519/planar-cell-polarity-signaling-in-mammalian-cardiac-morphogenesis
#7
Ding Li, Jianbo Wang
The mammalian heart is the first organ to form and is critical for embryonic survival and development. With an occurrence of 1%, congenital heart defects (CHDs) are also the most common birth defects in humans, and major cause of childhood morbidity and mortality (Hoffman and Kaplan in J Am Coll Cardiol 39(12):1890-1900, 2002; Samanek in Cardiol Young 10(3):179-185, 2000). Understanding how the heart forms will not only help to determine the etiology and to design diagnostic and therapeutic approaches for CHDs, but may also provide insight into regenerative medicine to repair injured adult hearts...
March 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29558937/measurement-variability-of-right-atrial-and-ventricular-monophasic-action-potential-and-refractory-period-measurements-in-the-standing-non-sedated-horse
#8
Dominique De Clercq, Barbara Broux, Lisse Vera, Annelies Decloedt, Gunther van Loon
BACKGROUND: In human and veterinary medicine, monophasic action potential (MAP) analysis and determination of local refractory periods by contact electrode technique gives valuable information about local cardiac electrophysiological properties. It is used to investigate dysrhythmias and the impact of drugs on the myocardium. Precise measurement of total MAP duration is difficult, therefore the MAP duration is usually determined at a repolarization level of 90% (APD90). Until now, no studies are published about the feasibility of this technique in the standing non-sedated horse...
March 20, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29555771/precision-medicine-screening-using-whole-genome-sequencing-and-advanced-imaging-to-identify-disease-risk-in-adults
#9
Bradley A Perkins, C Thomas Caskey, Pamila Brar, Eric Dec, David S Karow, Andrew M Kahn, Ying-Chen Claire Hou, Naisha Shah, Debbie Boeldt, Erin Coughlin, Gabby Hands, Victor Lavrenko, James Yu, Andrea Procko, Julia Appis, Anders M Dale, Lining Guo, Thomas J Jönsson, Bryan M Wittmann, Istvan Bartha, Smriti Ramakrishnan, Axel Bernal, James B Brewer, Suzanne Brewerton, William H Biggs, Yaron Turpaz, J Craig Venter
Reducing premature mortality associated with age-related chronic diseases, such as cancer and cardiovascular disease, is an urgent priority. We report early results using genomics in combination with advanced imaging and other clinical testing to proactively screen for age-related chronic disease risk among adults. We enrolled active, symptom-free adults in a study of screening for age-related chronic diseases associated with premature mortality. In addition to personal and family medical history and other clinical testing, we obtained whole-genome sequencing (WGS), noncontrast whole-body MRI, dual-energy X-ray absorptiometry (DXA), global metabolomics, a new blood test for prediabetes (Quantose IR), echocardiography (ECHO), ECG, and cardiac rhythm monitoring to identify age-related chronic disease risks...
April 3, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29485570/pulling-and-pushing-stem-cells-to-control-their-differentiation
#10
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...
May 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29455777/palliative-treatment-of-coronary-atherosclerotic-cancer-by-drug-eluting-or-bare-metal-stents-from-oculo-stenotic-reflex-period-to-age-of-precision-medicine
#11
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
https://www.readbyqxmd.com/read/29452273/3d-bioprinted-functional-and-contractile-cardiac-tissue-constructs
#12
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...
April 1, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29423881/the-curious-tale-of-perioperative-precision-medicine-a-story-of-hydroxocobalamin-and-cardiac-surgery-associated-vasoplegia
#13
EDITORIAL
Miklos D Kertai, Andrew D Shaw
No abstract text is available yet for this article.
May 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29407013/contemporary-emergency-department-management-of-patients-with-chest-pain-a-concise-review-and-guide-for-the-high-sensitivity-troponin-era
#14
REVIEW
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
https://www.readbyqxmd.com/read/29381054/mesh-nanoelectronics-seamless-integration-of-electronics-with-tissues
#15
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...
February 20, 2018: Accounts of Chemical Research
https://www.readbyqxmd.com/read/29370821/phenodis-a-comprehensive-database-for-phenotypic-characterization-of-rare-cardiac-diseases
#16
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
https://www.readbyqxmd.com/read/29261360/precision-medicine-functional-advancements
#17
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...
January 29, 2018: Annual Review of Medicine
https://www.readbyqxmd.com/read/29236642/noninvasive-cardiac-radiation-for-ablation-of-ventricular-tachycardia
#18
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
#19
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
#20
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
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