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Reduced ejection fraction

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https://www.readbyqxmd.com/read/28544120/prognostic-significance-of-aortic-valve-gradient-in-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#1
Guy Witberg, Arik Finkelstein, Issi Barbash, Abid Assali, Yaron Shapira, Amit Segev, Amir Halkin, Paul Fefer, Jeremy Ben-Shoshan, Maayan Konigstein, Alexander Sagie, Victor Guetta, Ran Kornowski, Alon Barsheshet
OBJECTIVE: To evaluate the effect of baseline aortic valve gradient (AVG) both as a continuous and a categorical variable on mortality in patients undergoing transcatheter aortic valve replacement (TAVR), focusing on the high-gradient severe aortic stenosis (AS) patients. BACKGROUND: Identifying new predictors of mortality in the TAVR population can help refine risk stratification and improve the patient selection process for this procedure. So far, AVG has mainly been studied as a categorical variable and there is a paucity of data on its prognostic value as a continuous variable, especially in patients with high AVG AS, who constitute the majority of patients referred for TAVR...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28543352/effect-of-albiglutide-on-cholecystokinin-induced-gallbladder-emptying-in-healthy-individuals-a-randomized-crossover-study
#2
Bonnie C Shaddinger, Malcolm A Young, Julia Billiard, David A Collins, Azra Hussaini, Antonio Nino
The glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) exenatide and lixisenatide reduce cholecystokinin (CCK)-induced gallbladder emptying in healthy subjects. It is unknown if all GLP-1 RAs share this effect; therefore, the effect of the GLP-1 RA albiglutide on gallbladder function was assessed. In this randomized, double-blind, 2-way crossover study, a single dose of subcutaneous albiglutide 50 mg or placebo was administered to 17 healthy subjects, and CCK-induced gallbladder contractility was measured by ultrasonography...
May 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#3
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28542926/effect-of-spironolactone-on-exercise-tolerance-and-arterial-function-in-older-adults-with-heart-failure-with-preserved-ejection-fraction
#4
Bharathi Upadhya, William G Hundley, Peter H Brubaker, Timothy M Morgan, Kathryn P Stewart, Dalane W Kitzman
OBJECTIVES: To evaluate the effects of an aldosterone antagonist on exercise intolerance in older adults with heart failure and preserved ejection fraction (HFpEF). DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: Academic medical center, Winston-Salem, North Carolina. PARTICIPANTS: Older adults (N = 80, aged 71 ± 1; 80% female) with stable compensated HFpEF and controlled blood pressure (BP)...
May 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28541594/interatrial-shunt-device-iasd%C3%A2-implantation-a-novel-treatment-method-for-heart-failure-with-preserved-ejection-fraction
#5
Michał Kosowski, Piotr Kübler, Adam Kołodziej, Bartosz Krakowiak, Dorota Kustrzycka-Kratochwil, Janusz Sławin, Mateusz Sokolski, Jan Biegus, Robert Zymliński, Waldemar Banasiak, Piotr Ponikowski, Krzysztof Reczuch
Heart failure with preserved ejection fraction (HFpEF) is a condition with complex pathophysiology and clinical profile. No treatment has been proven to reduce mortality or reduce morbidity in a meaningful way. In the era of percutaneous cardiac interventions, a novel method of reducing left atrial pressure by creating an iatrogenic interatrial shunt has been introduced. We present a report of implantation of InterAtrial Shunt Device (IASD®) in three consecutive patients.
May 25, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28540882/carnitine-reduced-erythropoietin-dose-required-and-improved-cardiac-function-of-patients-on-maintenance-hemodialysis
#6
Yosuke Aoki, Takako Yamamoto
Intravenous administration of 2 g carnitine in every hemodialysis (3 times/week), for 8-10 months, reduced doses of darbepoetin alfa required to maintain adequate hemoglobin levels (10-11 g/dL) into 10% of the initial doses. There was also a significant increase in plasma transferrin saturation, increase in left ventricular ejection fraction, and decrease in plasma brain natriuretic peptides.
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#7
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28538762/papillary-muscle-free-strain-in-patients-with-severe-degenerative-and-functional-mitral-regurgitation
#8
Alev Kılıcgedik, Gokhan Kahveci, Ahmet Seyfeddin Gurbuz, Can Yucel Karabay, Ahmet Guler, Suleyman Cagan Efe, Soe Moe Aung, Ugur Arslantas, Serdar Demir, Ibrahim Akin Izgi, Cevat Kirma
Fundamento: The role of papillary muscle function in severe mitral regurgitation with preserved and reduced left ventricular ejection fraction and the method of choice to evaluate PM have still been the subjects of controversy. Objectives: To evaluate and compare papillary muscle function in and between patients with severe degenerative and functional mitral regurgitation by using the free strain method. Methods: 64 patients with severe mitral regurgitation - 39 patients with degenerative mitral regurgitation (DMR group) and 25 patients with severe functional mitral regurgitation (FMR group) - and 30 control subjects (control group) were included in the study...
April 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28536092/a-personalized-and-interactive-web-based-health-care-innovation-to-advance-the-quality-of-life-and-care-of-patients-with-heart-failure-acquire-hf-a-mixed-methods-feasibility-study
#9
Susanne S Pedersen, Thomas Schmidt, Søren Jensen Skovbakke, Uffe Kock Wiil, Kenneth Egstrup, Kim G Smolderen, John A Spertus
BACKGROUND: Heart failure (HF) is a progressive, debilitating, and complex disease, and due to an increasing incidence and prevalence, it represents a global health and economic problem. Hence, there is an urgent need to evaluate alternative care modalities to current practice to safeguard a high level of care for this growing population. OBJECTIVE: Our goal was to examine the feasibility of engaging patients to use patient-centered and personalized tools coupled with a Web-based, shared care and interactive platform in order to empower and enable them to live a better life with their disease...
May 23, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28533317/cardiovascular-toxicity-of-illicit-anabolic-androgenic-steroid-use
#10
Aaron L Baggish, Rory B Weiner, Gen Kanayama, James I Hudson, Michael T Lu, Udo Hoffmann, Harrison G Pope
BACKGROUND: Millions of individuals have used illicit anabolic-androgenic steroids (AAS), but the long-term cardiovascular associations of these drugs remain incompletely understood. METHODS: Using a cross-sectional cohort design, we recruited 140 experienced male weightlifters 34 to 54 years of age, comprising 86 men reporting ≥2 years of cumulative lifetime AAS use and 54 nonusing men. Using transthoracic echocardiography and coronary computed tomography angiography, we assessed 3 primary outcome measures: left ventricular (LV) systolic function (left ventricular ejection fraction), LV diastolic function (early relaxation velocity), and coronary atherosclerosis (coronary artery plaque volume)...
May 23, 2017: Circulation
https://www.readbyqxmd.com/read/28532779/meta-analysis-of-risk-of-ventricular-arrhythmias-after-improvement-in-left-ventricular-ejection-fraction-during-follow-up-in-patients-with-primary-prevention-implantable-cardioverter-defibrillators
#11
Aiman Smer, Alok Saurav, Muhammad Soubhi Azzouz, Mohsin Salih, Mohamed Ayan, Ahmed Abuzaid, Abhilash Akinapelli, Arun Kanmanthareddy, Lynda E Rosenfeld, Faisal M Merchant, Hussam Abuissa
Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden cardiac death in patients with impaired left ventricular ejection fraction (LVEF). However, there are limited data on the long-term benefit of ICD therapy in patients whose LVEF subsequently improves. We conducted a meta-analysis to evaluate the effect of LVEF improvement on ICD therapy during follow-up. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using random-effects modeling. Sixteen studies with 3,959 patients were included in our analysis...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28532775/prognostic-implications-of-mid-range-left-ventricular-ejection-fraction-on-patients-presenting-with-st-segment-elevation-myocardial-infarction
#12
Gilad Margolis, Shafik Khoury, Jeremy Ben-Shoshan, Sevan Letourneau-Shesaf, Nir Flint, Gad Keren, Yacov Shacham
The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction, recognizing patients with mid-range EF (mrEF; 40% to 49%) as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes, and long-term mortality of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention who had mrEF. We conducted a retrospective study of 2,086 consecutive patients with STEMI between December 2007 and June 2016 who underwent primary percutaneous coronary intervention and had a comprehensive echocardiographic examination performed within 72 hours of hospital admission...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28532770/changes-in-loop-diuretic-dose-and-outcome-after-cardiac-resynchronization-therapy-in-patients-with-heart-failure-and-reduced-left-ventricular-ejection-fractions
#13
Pieter Martens, Frederik H Verbrugge, Petra Nijst, Matthias Dupont, Wilfried Mullens
Cardiac resynchronization therapy (CRT) improves cardiac hemodynamics. Therefore, the maintenance dose of loop diuretic therapy might be reduced. Consecutive patients who underwent CRT (n = 648) were retrospectively evaluated. Loop diuretic dose was recorded at baseline before implantation and 6 months later with patients classified into 4 groups: (1) no loop diuretic, (2) down-titration, (3) unchanged dose, and (4) up-titration. Afterward total loop diuretic exposure was calculated. Renal function trajectories were evaluated as the difference between implantation and censoring serum creatinine (Cr) value...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28531295/right-ventricular-vascular-coupling-in-heart-failure-with-preserved-ejection-fraction-and-pre-vs-post-capillary-pulmonary-hypertension
#14
Thomas M Gorter, Dirk J van Veldhuisen, Adriaan A Voors, Yoran M Hummel, Carolyn S P Lam, Rolf M F Berger, Joost P van Melle, Elke S Hoendermis
Aims: Many patients with heart failure with preserved ejection fraction (HFpEF) develop post-capillary pulmonary hypertension (PH) due to increased left-sided filling pressures. However, a subset of patients develops combined post- and pre-capillary PH. We studied the value of echocardiographic right-sided characterization for the discrimination between pre- vs. post-capillary PH in HFpEF, using invasive haemodynamics as gold standard. Methods and results: 102 consecutive HFpEF patients with simultaneous right heart catheterization and echocardiography were identified...
May 22, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28531281/standard-vs-intensified-management-of-heart-failure-to-reduce-healthcare-costs-results-of-a-multicentre-randomized-controlled-trial
#15
P A Scuffham, J Ball, J D Horowitz, C Wong, P J Newton, P Macdonald, J McVeigh, A Rischbieth, N Emanuele, M J Carrington, C M Reid, Y K Chan, S Stewart
Aims: To determine if an intensified form of heart failure management programme (INT-HF-MP) based on individual profiling is superior to standard management (SM) in reducing health care costs during 12-month follow-up (primary endpoint). Methods and results: A multicentre randomized trial involving 787 patients (full analysis set) discharged from four tertiary hospitals with chronic HF who were randomized to SM (n = 391) or INT-HF-MP (n = 396). Mean age was 74 ± 12 years, 65% had HF with a reduced ejection fraction (31...
May 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#16
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28528982/influence-of-renal-dysfunction-phenotype-on-mortality-in-decompensated-heart-failure-with-preserved-and-mid-range-ejection-fraction
#17
Jesús Casado, Marta Sánchez, Vanesa Garcés, Luis Manzano, José Manuel Cerqueiro, Francisco Epelde, David García-Escrivá, José Pérez-Silvestre, José Luis Morales, Manuel Montero-Pérez-Barquero
BACKGROUND: Natriuretic peptides or the blood urea nitrogen to creatinine ratio (BUN/creat) can identify high- vs low-risk renal impairment (RI) in patients with heart failure and reduced ejection fraction (HF-REF). However, the situation in HF patients with preserved ejection fraction (HF-PEF) and mid-range ejection fraction (HF-MREF) remains unclear. METHODS: We evaluated patients from the Spanish National Registry of Heart Failure (RICA) that were admitted to Internal Medicine units with acute decompensated HF...
May 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28528324/new-role-for-interleukin-13-receptor-%C3%AE-1-in-myocardial-homeostasis-and-heart-failure
#18
Uri Amit, David Kain, Allon Wagner, Avinash Sahu, Yael Nevo-Caspi, Nir Gonen, Natali Molotski, Tal Konfino, Natalie Landa, Nili Naftali-Shani, Galia Blum, Emmanuelle Merquiol, Danielle Karo-Atar, Yariv Kanfi, Gidi Paret, Ariel Munitz, Haim Y Cohen, Eytan Ruppin, Sridhar Hannenhalli, Jonathan Leor
BACKGROUND: The immune system plays a pivotal role in myocardial homeostasis and response to injury. Interleukins-4 and -13 are anti-inflammatory type-2 cytokines, signaling via the common interleukin-13 receptor α1 chain and the type-2 interleukin-4 receptor. The role of interleukin-13 receptor α1 in the heart is unknown. METHODS AND RESULTS: We analyzed myocardial samples from human donors (n=136) and patients with end-stage heart failure (n=177). We found that the interleukin-13 receptor α1 is present in the myocardium and, together with the complementary type-2 interleukin-4 receptor chain Il4ra, is significantly downregulated in the hearts of patients with heart failure...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28527109/erratum-to-clinical-pharmacokinetics-of-sacubitril-valsartan-lcz696-a-novel-angiotensin-receptor-neprilysin-inhibitor
#19
Surya Ayalasomayajula, Thomas Langenickel, Parasar Pal, Sreedevi Boggarapu, Gangadhar Sunkara
Sacubitril/valsartan (LCZ696) is indicated for the treatment of heart failure with reduced ejection fraction. Absorption of sacubitril/valsartan and conversion of sacubitril (prodrug) to sacubitrilat (neprilysin inhibitor) was rapid with maximum plasma concentrations of sacubitril, sacubitrilat, and valsartan (angiotensin receptor blocker) reaching within 0.5, 1.5-2.0, and 2.0-3.0 h, respectively. With a twofold increase in dose, an increase in the area under the plasma concentration-time curve was proportional for sacubitril, ~1...
May 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28526653/genetic-variants-of-interleukin-18-are-associated-with-reduced-risk-of-atrial-fibrillation-in-a-population-from-northeast-china
#20
Ying-Hui Wang, Lin Fu, Bo Wang, Shu-Feng Li, Zhao Sun, Ying Luan
Atrial fibrillation (AF) affects approximately 1-2% of general population. Chronic inflammation plays an important role in AF development and interleukin-18 (IL-18) is a pro-inflammatory cytokine. This study aimed to assess the association of single nucleotide polymorphisms (SNPs) of IL-18 for with AF risk. Blood samples were taken from 243 AF patients and 160 non-AF individuals from a Chinese population and subjected to genotyping for six IL-18 SNPs using the MassArray system. Association of individual SNPs with AF risk was analyzed using SAS version 9...
May 16, 2017: Gene
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