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https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#1
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27900955/serum-levels-of-n-terminal-pro-b-type-natriuretic-peptide-as-a-diagnostic-marker-for-left-ventricular-dysfunction-in-children-with-end-stage-renal-disease-on-hemodialysis
#2
Amr Mohamed Zoair, Maher Ahmed Abdel-Hafez, Wegdan Mawlana, Mohamed Abdel-Rahman Sweylam
The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP) as a marker of left ventricular (LV) dysfunction in children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27899894/moderate-load-eccentric-exercise-a-distinct-novel-training-modality
#3
REVIEW
Hans Hoppeler
Over the last 20 years a number of studies have been published using progressive eccentric exercise protocols on motorized ergometers or similar devices that allow for controlled application of eccentric loads. Exercise protocols ramp eccentric loads over an initial 3 weeks period in order to prevent muscle damage and delayed onset muscle soreness. Final training loads reach 400-500 W in rehabilitative settings and over 1200 W in elite athletes. Training is typically carried out three times per week for durations of 20-30 min...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27898524/uromodulin-in-kidney-health-and-disease
#4
Pranav S Garimella, Mark J Sarnak
PURPOSE OF REVIEW: Although uromodulin or Tamm-Horsfall protein was discovered over 60 years ago, its functional role in humans remains unclear. This review highlights new studies elucidating the clinical correlates of uromodulin, its association with kidney function decline, nephrolithiasis and urinary host defense. RECENT FINDINGS: Uromodulin is evolutionarily conserved and has multiple functional roles. In large population studies, higher levels of uromodulin are associated with higher estimated glomerular filtration rate (eGFR) and kidney size, possibly indicating greater kidney functional reserve...
November 24, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27896910/novel-delivery-technique-for-atrial-septal-defect-closure-in-young-children-utilizing-the-gore-%C3%A2-cardioform-%C3%A2-septal-occluder
#5
Jason H Anderson, Hannah Fraint, Phillip Moore, Allison K Cabalka, Nathaniel W Taggart
OBJECTIVES: To develop a novel delivery technique to overcome vascular size limitations for device closure of a secundum ASD in the young patient. BACKGROUND: The efficacy, clinical utility, and safety of transcatheter closure in comparison to surgical closure are well established; however, access vessel size remains a potential limitation to device selection in the young patient. METHODS: A retrospective medical record review of all cases of secundum ASD closure between April 2015 and April 2016 utilizing a novel delivery method described herein at two separate academic institutions...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27883326/renal-replacement-therapy-in-patients-with-heart-and-kidney-failure
#6
Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou
The incidence of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) is high as CKD and CHF share underlying risk factors such as arterial hypertension, diabetes mellitus and atherosclerosis. Cardiac failure leads to renal hypoperfusion and dysfunction and then fluid overload and need for aggressive diuretic therapy. However, development of diuretic resistance represents a significant problem in the management of these patients. The role of Renal Replacement Therapy (RRT) is important for patients who do not response to conservative management of fluid overload facilitating the failing heart to restore function...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27882423/cardio-ankle-vascular-index-cavi-and-plasma-transforming-growth-factor-%C3%AE-1-tgf-%C3%AE-1-level-correlate-with-aortopathy-in-adults-with-repaired-tetralogy-of-fallot
#7
Yumi Shiina, Koichiro Niwa
It is challenging to evaluate aortopathy in congenital heart disease using conventional investigations such as brachial-ankle pulse wave velocity (baPWV). Therefore, we evaluated the cardio-ankle vascular index (CAVI), a dimension of the ascending aorta and plasma transforming growth factor-β1 (TGF-β1) level, in order to find novel noninvasive parameters of aortopathy in adults with repaired tetralogy of Fallot (TOF). Prospectively, we enrolled 42 consecutive adults with TOF (28 patients with repaired TOF were not on ARB, 8 patients with repaired TOF on ARB, 6 patients with no repair or only palliative repair) and 20 age-matched healthy controls...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27870968/the-cardiac-maladaptive-atf3-dependent-cross-talk-between-cardiomyocytes-and-macrophages-is-mediated-by-the-ifn%C3%AE-cxcl10-cxcr3-axis
#8
L Koren, U Barash, Y Zohar, N Karin, A Aronheim
RATIONAL: Pressure overload induces adaptive and maladaptive cardiac remodeling processes in the heart. Part of the maladaptive process is the cross-talk between cardiomyocytes and macrophages which is dependent on the function of the Activating Transcription Factor 3, ATF3. Yet, the molecular mechanism involved in cardiomyocytes-macrophages communication leading to macrophages recruitment to the heart and cardiac maladaptive remodeling is currently unknown. METHODS AND RESULTS: Isolated peritoneal macrophages from either wild type or ATF3-KO mice were cultured in serum free medium to collect conditioned medium (CM)...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867086/diazoxide-prevents-reactive-oxygen-species-and-mitochondrial-damage-leading-to-anti-hypertrophic-effects
#9
Aline M Lucas, Francisco R Caldas, Amanda P da Silva, Maximiano M Ventura, Iago M Leite, Ana B Filgueiras, Claúdio G L Silva, Alicia J Kowaltowski, Heberty T Facundo
Pathological cardiac hypertrophy is characterized by wall thickening or chamber enlargement of the heart in response to pressure or volume overload, respectively. This condition will, initially, improve the organ contractile function, but if sustained will render dysfunctional mitochondria and oxidative stress. Mitochondrial ATP-sensitive K(+) channels (mitoKATP) modulate the redox status of the cell and protect against several cardiac insults. Here, we tested the hypothesis that mitoKATP opening (using diazoxide) will avoid isoproterenol-induced cardiac hypertrophy in vivo by decreasing reactive oxygen species (ROS) production and mitochondrial Ca(2+)-induced swelling...
November 17, 2016: Chemico-biological Interactions
https://www.readbyqxmd.com/read/27865733/systolic-and-diastolic-unloading-by-mechanical-support-of-the-acute-vs-the-chronic-pressure-overloaded-right-ventricle
#10
Tom Verbelen, Daniel Burkhoff, Keiichiro Kasama, Marion Delcroix, Filip Rega, Bart Meyns
BACKGROUND: Right ventricular (RV) mechanical support is well described in cases of sudden increase in RV afterload. In cases of chronic RV pressure overload (e.g., pulmonary arterial hypertension), it has rarely been described. METHODS: The pulmonary artery was banded in 18 sheep. In the acute group (n = 9), we immediately implanted a Synergy Pocket Micro-Pump. Blood was withdrawn from the right atrium to the pulmonary artery. In the chronic group (n = 9), this pump was implanted 8 weeks after banding...
October 17, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27864463/increased-brain-hemopexin-levels-improve-outcomes-after-intracerebral-hemorrhage
#11
Jenna L Leclerc, Juan Santiago-Moreno, Alex Dang, Andrew S Lampert, Pedro E Cruz, Awilda M Rosario, Todd E Golde, Sylvain Doré
Following intracerebral hemorrhage (ICH), extracellular heme precipitates secondary brain injury, which results in irreversible brain damage and enduring neurological deficits. Hemopexin (Hpx) is an endogenous protein responsible for scavenging heme, thereby modulating its intrinsic proxidant/proinflammatory properties. Although Hpx is present in the brain, the endogenous levels are insufficient to combat the massive heme overload following ICH. We hypothesized that increasing brain Hpx levels would improve ICH outcomes...
November 18, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27863290/cardiorenal-acute-kidney-injury-epidemiology-presentation-causes-pathophysiology-and-treatment
#12
REVIEW
Luca Di Lullo, Antonio Bellasi, Domenico Russo, Mario Cozzolino, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist; this organ - organ interaction, also called organ cross-talk led to well-known definition of cardiorenal syndrome (CRS). Here we'll describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#13
REVIEW
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27855803/long-term-outcomes-in-patients-with%C3%A2-aortic-regurgitation-and-preserved%C3%A2-left-ventricular-ejection-fraction
#14
Amgad Mentias, Ke Feng, Alaa Alashi, L Leonardo Rodriguez, A Marc Gillinov, Douglas R Johnston, Joseph F Sabik, Lars G Svensson, Richard A Grimm, Brian P Griffin, Milind Y Desai
BACKGROUND: Chronic severe aortic regurgitation (AR) imposes significant volume and pressure overload on the left ventricle (LV), but such patients typically remain in an asymptomatic state for a very long time. OBJECTIVES: This study sought to examine long-term outcomes in a contemporary group of patients with grade III+ chronic AR and preserved left ventricular ejection fraction (LVEF) and the value of aortic valve (AV) surgery on long-term survival. We also wanted to reassess the threshold of LV dimension, beyond which mortality significantly increases...
November 15, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27835958/identification-of-volume-overload-hospitalizations-among-hemodialysis-patients-using-administrative-claims-a-validation-study
#15
Magdalene M Assimon, Thuy Nguyen, Suzanne L Katsanos, Steven M Brunelli, Jennifer E Flythe
BACKGROUND: High rates of volume overload hospitalizations may indicate inadequate dialysis facility fluid management. Administrative claims databases are often used to study such outcomes, but these data are generated for billing purposes and may not capture clinical nuance. It is unknown if volume overload admissions can be correctly identified in administrative data and if a single claims-based definition for volume overload can be used across epidemiologic surveillance studies, observational studies of exposure-outcome associations and quality assessments...
November 11, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27832647/extracellular-volume-overload-and-increased-vasoconstriction-in-patients-with-recurrent-intradialytic-hypertension
#16
Peter Noel Van Buren, Yunyun Zhou, Javier A Neyra, Guanghua Xiao, Wanpen Vongpatanasin, Jula Inrig, Robert Toto
BACKGROUND/AIMS: Intradialytic hypertension (IH) occurs frequently in some hemodialysis patients and increases mortality risk. We simultaneously compared pre-dialysis, post-dialysis and changes in extracellular volume and hemodynamics in recurrent IH patients and controls. METHODS: We performed a case-control study among prevalent hemodialysis patients with recurrent IH and hypertensive hemodialysis controls. We used bioimpedance spectroscopy and impedance cardiography to compare pre-dialysis, post-dialysis, and intradialytic change in total body water (TBW) and extracellular water (ECW), as well as cardiac index (CI) and total peripheral resistance index (TPRI)...
November 11, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27825364/mid-regional-pro-adrenomedullin-mr-proadm-a-marker-of-positive-fluid-balance-in-critically-ill-patients-results-of-the-envol-study
#17
Bernard Vigué, Pierre-Etienne Leblanc, Frédérique Moati, Eric Pussard, Hussam Foufa, Aurore Rodrigues, Samy Figueiredo, Anatole Harrois, Jean-Xavier Mazoit, Homa Rafi, Jacques Duranteau
BACKGROUND: The optimal control of blood volume without fluid overload is a main challenge in the daily care of intensive care unit (ICU) patients. Accordingly this study focused on the identification of biomarkers to help characterize fluid overload status. METHODS: Sixty-seven patients were studied from ICU admission to day 7 (D7). Blood and urine samples were taken daily and sodium and water balance strictly calculated resulting in a total cumulative assessment of ∆Na(+) and ∆H2O...
November 9, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27823598/serum-potassium-levels-and-outcome-in-acute-heart-failure-data-from-the-protect-and-coach-trials
#18
Jasper Tromp, Jozine M Ter Maaten, Kevin Damman, Christopher M O'Connor, Marco Metra, Howard C Dittrich, Piotr Ponikowski, John R Teerlink, Gad Cotter, Beth Davison, John G F Cleland, Michael M Givertz, Daniel M Bloomfield, Martje H L van der Wal, Tiny Jaarsma, Dirk J van Veldhuisen, Hans L Hillege, Adriaan A Voors, Peter van der Meer
Serum potassium is routinely measured at admission for acute heart failure (AHF), but information on association with clinical variables and prognosis is limited. Potassium measurements at admission were available in 1,867 patients with AHF in the original cohort of 2,033 patients included in the Patients Hospitalized with acute heart failure and Volume Overload to Assess Treatment Effect on Congestion and Renal FuncTion trial. Patients were grouped according to low potassium (<3.5 mEq/l), normal potassium (3...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27821636/potentially-preventable-hospitalization-among-patients-with-ckd-and-high-inpatient-use
#19
Paul E Ronksley, Brenda R Hemmelgarn, Braden J Manns, James Wick, Matthew T James, Pietro Ravani, Robert R Quinn, Nairne Scott-Douglas, Richard Lewanczuk, Marcello Tonelli
BACKGROUND AND OBJECTIVES: Although patients with CKD are commonly hospitalized, little is known about those with frequent hospitalization and/or longer lengths of stay (high inpatient use). The objective of this study was to explore clinical characteristics, patterns of hospital use, and potentially preventable acute care encounters among patients with CKD with at least one hospitalization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We identified all adults with nondialysis CKD (eGFR<60 ml/min per 1...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27817003/obstructive-ventilatory-disorder-in-heart-failure-caused-by-the-heart-or-the-lung
#20
REVIEW
Sergio Caravita, Jean-Luc Vachiéry
Heart failure (HF) is a clinical syndrome frequently associated with airway obstruction, either as a respiratory comorbidity or as a direct consequence of HF pathophysiology. Recognizing the relative contribution of an underlying airway disease as opposed to airway obstruction due to volume overload and left atrial pressure elevation is of importance for the appropriate management of patients affected by HF. This review focuses on "les liaisons dangereuses" between the heart and the lungs, outlying recent advances linking in a vicious circle of chronic obstructive lung disease (COPD) and obstructive sleep apnea (OSA) on one side and HF on the other side...
November 5, 2016: Current Heart Failure Reports
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