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Cardiac precision medicine

Shweta R Motiwala, Hanna K Gaggin
Left ventricular remodeling appears to be a critical link between cardiac injury and the development and progression of heart failure with reduced ejection fraction (HFrEF). Several drug and device therapies that modify and reverse the remodeling process in patients with HFrEF are closely associated with improvement in clinical outcomes. Reverse remodeling, including partial or complete recovery of systolic function and structure, is possible but its determinants are incompletely understood. Methods to predict reverse remodeling in response to therapy are not well defined...
October 10, 2016: Current Heart Failure Reports
Aaron J Rogers, Vladimir G Fast, Palaniappan Sethu
Induced pluripotent stem cell derived cardiomyocytes (iPSC-CMs) provide a human source of cardiomyocytes for use in cardiovascular research and regenerative medicine. However, attempts to use these cells in vivo have resulted in drastic cell death caused by mechanical, metabolic, and/or exogenous factors. To explore this issue, we designed a Biomimetic Cardiac Tissue Model (BCTM) where various parameters associated with heart function including heart rate, peak-systolic pressure, end-diastolic pressure and volume, end-systolic pressure and volume, and ratio of systole to diastole can all be precisely manipulated to apply hemodynamic loading to culture cells...
October 4, 2016: Analytical Chemistry
Jens P Goetze, Nora E Zois
No abstract text is available yet for this article.
October 2016: Lancet Diabetes & Endocrinology
Achal Singh Achrol, Gary K Steinberg
Cerebral aneurysms are common vascular lesions. Little is known about the pathogenesis of these lesions and the process by which they destabilize and progress to rupture. Treatment decisions are motivated by a desire to prevent rupture and the devastating morbidity and mortality associated with resulting subarachnoid hemorrhage (SAH). For patients presenting with SAH, urgent intervention is required to stabilize the lesion and prevent re-rupture. Those patients fortunate enough to survive a presenting SAH and subsequent securing of their aneurysm must still face a spectrum of secondary sequelae, which can include cerebral vasospasm, delayed ischemia, seizures, cerebral edema, hydrocephalus, and endocrinologic and catecholamine-induced systemic dysfunction in cardiac, pulmonary, and renal systems...
2016: Frontiers in Surgery
Siobhan Corcoran, Kaleigh Briggs, Hugh O' Connor, Sieglinde Mullers, Cathy Monteith, Jennifer Donnelly, Patrick Dicker, Orla Franklin, Fergal D Malone, Fionnuala M Breathnach
INTRODUCTION: Congenital heart disease (CHD) is the most common major structural fetal abnormality and the benefits of prenatal detection are well described. The objective of this study was to evaluate the precision of prenatal diagnosis at a single tertiary referral unit over two three year periods (2006, 2007, 2008 and 2010, 2011, 2012), before and after a prenatal screening protocol for CHD was developed to include extended cardiac views, mandatory recall for suboptimal views, and a multidisciplinary Fetal Cardiac clinic was established...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Elena Matsa, John H Ahrens, Joseph C Wu
Human induced pluripotent stem cells (hiPSCs) have revolutionized the field of human disease modeling, with an enormous potential to serve as paradigm shifting platforms for preclinical trials, personalized clinical diagnosis, and drug treatment. In this review, we describe how hiPSCs could transition cardiac healthcare away from simple disease diagnosis to prediction and prevention, bridging the gap between basic and clinical research to bring the best science to every patient.
July 2016: Physiological Reviews
Li Qian
No abstract text is available yet for this article.
June 17, 2016: Science
M Odette Gore, James A de Lemos
No abstract text is available yet for this article.
June 2016: Circulation. Cardiovascular Interventions
Matthew C White, Li Pang, Xi Yang
Human pluripotent stem cell-derived cardiomyocytes (PSC-CMs) are a promising human cardiac model system for drug development and toxicity screening, along with cell therapy and mechanistic research. The scalable differentiation of human PSCs into CMs provides a renewable cell source that overcomes species differences present in rodent primary CMs. In addition, induced pluripotent stem cell (iPSC) technology allows for development of patient-specific CMs, representing a valuable tool that may lead to better prediction, prevention, and treatment of cardiovascular diseases in this new era of precision medicine...
June 2, 2016: Food and Chemical Toxicology
Yanhang Zhang, Victor H Barocas, Scott A Berceli, Colleen E Clancy, David M Eckmann, Marc Garbey, Ghassan S Kassab, Donna R Lochner, Andrew D McCulloch, Roger Tran-Son-Tay, Natalia A Trayanova
Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models...
September 2016: Annals of Biomedical Engineering
Yoni Halpern, Steven Horng, Youngduck Choi, David Sontag
BACKGROUND: Electronic medical records (EMRs) hold a tremendous amount of information about patients that is relevant to determining the optimal approach to patient care. As medicine becomes increasingly precise, a patient's electronic medical record phenotype will play an important role in triggering clinical decision support systems that can deliver personalized recommendations in real time. Learning with anchors presents a method of efficiently learning statistically driven phenotypes with minimal manual intervention...
July 2016: Journal of the American Medical Informatics Association: JAMIA
Jamie D Kapplinger, Michael J Ackerman
No abstract text is available yet for this article.
April 2016: Circulation. Cardiovascular Genetics
A J Camm, I Savelieva, T Potpara, G Hindriks, L Pison, C Blömstrom-Lundqvist
The prevalence of atrial fibrillation (AF) in the general population is between 1% and 2% in the developed world and is higher in men than in women. The arrhythmia occurs much more commonly in the elderly, and the estimated lifetime risk of developing AF is one in four for men and women aged 40 years and above. Projected data from multiple population-based studies in the USA and Europe predict a two- to threefold increase in the number of AF patients by 2060. The high lifetime risk of AF and increased longevity underscore the important public health burden posed by this arrhythmia worldwide...
May 2016: Journal of Internal Medicine
Ghassan S Kassab, Gary An, Edward A Sander, Michael I Miga, Julius M Guccione, Songbai Ji, Yoram Vodovotz
In this era of tremendous technological capabilities and increased focus on improving clinical outcomes, decreasing costs, and increasing precision, there is a need for a more quantitative approach to the field of surgery. Multiscale computational modeling has the potential to bridge the gap to the emerging paradigms of Precision Medicine and Translational Systems Biology, in which quantitative metrics and data guide patient care through improved stratification, diagnosis, and therapy. Achievements by multiple groups have demonstrated the potential for (1) multiscale computational modeling, at a biological level, of diseases treated with surgery and the surgical procedure process at the level of the individual and the population; along with (2) patient-specific, computationally-enabled surgical planning, delivery, and guidance and robotically-augmented manipulation...
September 2016: Annals of Biomedical Engineering
De-Ann M Pillers, Nicholas H Von Bergen
Emery-Dreifuss muscular dystrophy (EDMD) is characterized by the clinical triad of scapulohumeroperoneal muscle weakness, joint contractures, and cardiac defects that include arrhythmias and dilated cardiomyopathy. Although there is a defining group of clinical findings, the proteins responsible and their underlying gene defects leading to EDMD are varied. A common aspect of the gene defects is their involvement in, or with, the nuclear envelope. Treatment approaches are largely based on clinical symptoms. The genetic diversity of EDMD predicts that a cure will ultimately depend upon the individual's defect at the gene level, making this an ideal candidate for a precision medicine approach...
2016: Application of Clinical Genetics
Chengguo Zhao, Fanxin Meng, Lulu Geng, Xi Zhao, Hui Zhou, Yao Zhang, Shuzhi Qin
Alatamine is a constituent in the extract of a traditional herbal medicine Ramulus euonymi widely used for cardiac protection. However, its precise effects remain unclear. In the present study, we found that alatamine was able to reduce acute myocardial ischemia (AMI)-induced cardiac dysfunction in a rat model, as reflected by significantly restored electrocardiograms, M-mode echocardiograms, and left ventricular hemodynamics. Also, Nagar Olsen staining revealed that alatamine markedly reduced AMI-induced cardiac injury and cardiac myocyte apoptosis...
April 2016: Canadian Journal of Physiology and Pharmacology
Tolga Karapinar, Yesari Eroksuz, Armagan Hayirli, Enver Beytut, Ozgur Kaynar, Ersoy Baydar, Ibrahim Sozdutmaz, Hakan Isidan
BACKGROUND: Cardiac troponin I (cTnI) is a peripheral blood marker for myocardial damage. Because of the unavailability of goat-specific cTnI assays human cTnI assays may be validated for detection of myocarditis in goat kids. OBJECTIVES: The purpose of the study was to evaluate 2 commercially available human cTnI assays in goat kids with myocardial damage, and to determine the cTnI expression in cardiac muscle. MATERIALS AND METHODS: Plasma cTnI concentrations were measured in healthy goat kids (n = 7) and goat kids with myocardial damage (n = 8) using the Beckman Coulter Access Accu TnI and the Biomérieux Vidas Ultra...
March 2016: Veterinary Clinical Pathology
William Gregory Feero
No abstract text is available yet for this article.
January 5, 2016: JAMA: the Journal of the American Medical Association
Chiao Xin Lim, Michael G Ricos, Leanne M Dibbens, Sarah E Heron
Mutations in the sodium-gated potassium channel subunit gene KCNT1 have recently emerged as a cause of several different epileptic disorders. This review describes the mutational and phenotypic spectrum associated with the gene and discusses the comorbidities found in patients, which include intellectual disability and psychiatric features. The gene may also be linked with cardiac disorders. KCNT1 missense mutations have been found in 39% of patients with the epileptic encephalopathy malignant migrating focal seizures of infancy (MMFSI), making it the most significant MMFSI disease-causing gene identified to date...
April 2016: Journal of Medical Genetics
Jiapeng Lu, Si Xuan, Nicholas S Downing, Chaoqun Wu, Li Li, Harlan M Krumholz, Lixin Jiang
INTRODUCTION: Collection of high-quality data from large populations is considered essential to generate knowledge that is critical to an era of precision medicine. Cardiovascular disease (CVD) is a leading cause of mortality in China and is a suitable focus of an initiative to discover factors that would improve our ability to assess and modify individual risk. METHODS AND ANALYSIS: The pilot phase of China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) Million Persons Project is being conducted during 2014-2015 in four provinces across China to demonstrate the feasibility of a population-based assessment...
2016: BMJ Open
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