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Reduced ejection fraction

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https://www.readbyqxmd.com/read/28938247/challenges-with-percent-predicted-maximum-vo2-in-patients-with-heart-failure
#1
Clinton A Brawner, Jonathan K Ehrman, Ali Shafiq, Matthew A Saval, Stuart D Russell, David E Lanfear, Steven J Keteyian
PURPOSE: To describe the influence of different equations to predict maximum oxygen uptake (MVO2) on the percent predicted MVO2 (ppMVO2) and the resultant categorization of patients with heart failure with reduced ejection fraction (HFrEF) into high or low risk. METHODS: In this retrospective cohort study, ppMVO2 was calculated using six different equations to predict MVO2 among 1,168 patients with HFrEF (33% women). Repeated measures analysis of variance was used to compare within-subject differences in mean ppMVO2 between the prediction equations...
September 21, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28935040/cardiopulmonary-exercise-testing-what-is-its-value
#2
REVIEW
Marco Guazzi, Francesco Bandera, Cemal Ozemek, David Systrom, Ross Arena
Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28934278/intercalated-disc-in-failing-hearts-from-patients-with-dilated-cardiomyopathy-its-role-in-the-depressed-left-ventricular-function
#3
Ana Ortega, Estefanía Tarazón, Carolina Gil-Cayuela, María García-Manzanares, Luis Martínez-Dolz, Francisca Lago, José Ramón González-Juanatey, Juan Cinca, Esther Jorge, Manuel Portolés, Esther Roselló-Lletí, Miguel Rivera
Alterations in myocardial structure and reduced cardiomyocyte adhesions have been previously described in dilated cardiomyopathy (DCM). We studied the transcriptome of cell adhesion molecules in these patients and their relationships with left ventricular (LV) function decay. We also visualized the intercalated disc (ID) structure and organization. The transcriptomic profile of 23 explanted LV samples was analyzed using RNA-sequencing (13 DCM, 10 control [CNT]), focusing on cell adhesion genes. Electron microscopy analysis to visualize ID structural differences and immunohistochemistry experiments of ID proteins was also performed...
2017: PloS One
https://www.readbyqxmd.com/read/28931652/responsive-monitoring-of-mitochondrial-redox-states-in-heart-muscle-predicts-impending-cardiac-arrest
#4
Dorothy A Perry, Joshua W Salvin, Padraic Romfh, Peili Chen, Kalyani Krishnamurthy, Lindsay M Thomson, Brian D Polizzotti, Francis X McGowan, Daryoosh Vakhshoori, John N Kheir
Assessing the adequacy of oxygen delivery to tissues is vital, particularly in the fields of intensive care medicine and surgery. As oxygen delivery to a cell becomes deficient, changes in mitochondrial redox state precede changes in cellular function. We describe a technique for the continuous monitoring of the mitochondrial redox state on the epicardial surface using resonance Raman spectroscopy. We quantify the reduced fraction of specific electron transport chain cytochromes, a metric we name the resonance Raman reduced mitochondrial ratio (3RMR)...
September 20, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#5
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925073/role-of-cardiopulmonary-exercise-testing-in-clinical-stratification-in-heart-failure-a-position-paper-from-the-committee-on-exercise-physiology-and-training-of-the-heart-failure-association-of-the-european-society-of-cardiology
#6
REVIEW
Ugo Corrà, Pier Giuseppe Agostoni, Stefan D Anker, Andrew J S Coats, Maria G Crespo Leiro, Rudolph A de Boer, Veli-Pekka Hairola, Loreena Hill, Mitja Lainscak, Lars H Lund, Marco Metra, Piotr Ponikowski, Jillian Riley, Petar M Seferović, Massimo F Piepoli
Traditionally, the main indication for cardiopulmonary exercise testing (CPET) in heart failure (HF) was for the selection of candidates to heart transplantation: CPET was mainly performed in middle-aged male patients with HF and reduced left ventricular ejection fraction. Today, CPET is used in broader patients' populations, including women, elderly, patients with co-morbidities, those with preserved ejection fraction, or left ventricular assistance device recipients, i.e. individuals with different responses to incremental exercise and markedly different prognosis...
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28925061/biomarkers-and-prognostication-in-heart-failure-with-reduced-and-preserved-ejection-fraction-similar-but-different
#7
EDITORIAL
Iain B Squire
No abstract text is available yet for this article.
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28923793/dose-comparison-study-of-allogeneic-mesenchymal-stem-cells-in-patients-with-ischemic-cardiomyopathy-the-trident-study
#8
Victoria Florea, Angela C Rieger, Darcy L Difede, Jill El-Khorazaty, Makoto Natsumeda, Monisha N Banerjee, Bryon A Tompkins, Aisha Khan, Ivonne H Schulman, Ana M Landin, Muzammil Mushtaq, Maureen H Lowery, John Byrnes, Robert C Hendel, Mauricio G Cohen, Krystalenia Valasaki, Marietsy V Pujol, Eduard Ghersin, Roberto Miki, Cindy Delgado, Fouad A Abuzeid, Mayra Vidro-Casiano, Russell Saltzman, Daniel DaFonseca, Lina V Caceres, Kevin N Ramdas, Adam Mendizabal, Alan W Heldman, Raul D Mitrani, Joshua M Hare
Rationale: Cell dose and concentration play crucial roles in phenotypic responses to cell-based therapy for heart failure. Objective: To compare the safety and efficacy of two doses of allogeneic bone marrow-derived human mesenchymal stem cells (hMSC) identically delivered in patients with ischemic cardiomyopathy (ICM). Methods and Results: Thirty patients with ICM received in a blinded manner either 20 million (20M, n=15) or 100 million (100M, n=15) allogeneic hMSCs via transendocardial injection (10 0.5 cc injections/patient)...
September 18, 2017: Circulation Research
https://www.readbyqxmd.com/read/28921674/decline-in-effort-capacity-with-age-echocardiographic-stress-analysis-in-the-elderly
#9
Anat Milman, Gad Keren, Yan Topilsky
BACKGROUND: The present study was designed to assess the underlying mechanism of decline in effort capacity seen with aging. METHODS: We analyzed 250 healthy senior patients (≥65 years) with an ejection fraction ≥60% who underwent a stress echocardiogram test. The seniors (aged 65-94) were divided into 3 equal age groups (groups 1, 2, and 3), and their echo characteristics at rest and peak exercise (measured and calculated) were compared. RESULTS: Diastolic function at rest declined significantly (E lateral, E septal, E/E', A) with age, while other rest parameters were similar...
September 17, 2017: Echocardiography
https://www.readbyqxmd.com/read/28921631/validation-of-highly-accelerated-real-time-cardiac-cine-mri-with-radial-k-space-sampling-and-compressed-sensing-in-patients-at-1-5t-and-3t
#10
Hassan Haji-Valizadeh, Amir A Rahsepar, Jeremy D Collins, Elwin Bassett, Tamara Isakova, Tobias Block, Ganesh Adluru, Edward V R DiBella, Daniel C Lee, James C Carr, Daniel Kim
PURPOSE: To validate an optimal 12-fold accelerated real-time cine MRI pulse sequence with radial k-space sampling and compressed sensing (CS) in patients at 1.5T and 3T. METHODS: We used two strategies to reduce image artifacts arising from gradient delays and eddy currents in radial k-space sampling with balanced steady-state free precession readout. We validated this pulse sequence against a standard breath-hold cine sequence in two patient cohorts: a myocardial infarction (n = 16) group at 1...
September 17, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28918108/heart-failure-with-recovered-ejection-fraction-in-african-americans-results-from-the-african-american-heart-failure-trial
#11
Kay-Won Chang, Neil Beri, Nghia H Nguyen, Boris Arbit, Sutton Fox, Sean Mojaver, Paul Clopton, S William Tam, Anne L Taylor, Jay N Cohn, Alan S Maisel, Inder S Anand
BACKGROUND: Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the first 6 months of follow-up. METHODS AND RESULTS: Subjects (n = 59) with HFrecEF (improvement in EF from < 35% to > 40% in 6 months) were compared to 259 with heart failure and persistently reduced EF (HFrEF), defined as EF ≤ 40% at 6 month follow-up...
September 13, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28917679/epidemiology-of-left-ventricular-systolic%C3%A2-dysfunction-and-heart-failure-in%C3%A2-the-framingham-study-an-echocardiographic-study-over-3-decades
#12
Ramachandran S Vasan, Vanessa Xanthakis, Asya Lyass, Charlotte Andersson, Connie Tsao, Susan Cheng, Jayashri Aragam, Emelia J Benjamin, Martin G Larson
OBJECTIVES: The purpose of this study was to describe the temporal trends in prevalence of left ventricular systolic dysfunction (LVSD) in individuals without and with heart failure (HF) in the community over a 3-decade period of observation. BACKGROUND: Temporal trends in the prevalence and management of major risk factors may affect the epidemiology of HF. METHODS: We compared the frequency, correlates, and prognosis of LVSD (left ventricular ejection fraction [LVEF] <50%) among Framingham Study participants without and with clinical HF in 3 decades (1985 to 1994, 1995 to 2004, and 2005 to 2014)...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917673/b-type-natriuretic-peptide-and-high-sensitivity-cardiac-troponin-for-risk-stratification-in-low-flow-low-gradient-aortic-stenosis-a-substudy-of-the-topas-study
#13
Abdellaziz Dahou, Marie-Annick Clavel, Romain Capoulade, Kim O'Connor, Henrique B Ribeiro, Nancy Côté, Florent Le Ven, Josep Rodés-Cabau, Jean G Dumesnil, Patrick Mathieu, Philippe Pibarot
OBJECTIVES: The objective of this study was to determine the prognostic value of combined measures of B-type natriuretic peptide (BNP) and high-sensitivity cardiac troponin T (hsTnT) in patients with low-flow, low-gradient aortic stenosis (LF-LG AS) who had either a preserved or reduced left ventricular ejection fraction (LVEF). BACKGROUND: An elevated BNP level is associated with increased risk of mortality in patients with LF-LG AS. The incremental prognostic value of hsTnT in these patients is unknown...
September 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28917559/predictors-and-outcomes-of-cardiac-resynchronization-therapy-extended-to-the-second-generator
#14
Xuping Li, Dachun Yang, Fred Kusumoto, Win-Guang Shen, Siva Mulpuru, Shenghua Zhou, Jinjun Liang, Gang Wu, Mei Yang, Jin-Qu Liu, Paul A Friedman, Yong-Mei Cha
BACKGROUND: A proportion of patients who receive cardiac resynchronization therapy (CRT) with defibrillator (CRT-D) live to receive a second generator. Controversy exists on whether an implantable cardioverter-defibrillator (ICD) should be offered to patients who have normalized or near normalized left ventricular ejection fraction (LVEF) at the time of generator replacement (GR). OBJECTIVE: To evaluate incidence of appropriate ICD therapy after CRT-D GR. METHODS: This series involved 1,026 consecutive patients who underwent CRT-D implant between January 2002 and December 2012...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28917011/prevalence-predictors-and-prognostic-implications-of-pr-interval-prolongation-in-patients-with-heart-failure
#15
Theodora Nikolaidou, Pierpaolo Pellicori, Jufen Zhang, Syed Kazmi, Kevin M Goode, John G Cleland, Andrew L Clark
AIMS: To determine the prevalence, incidence, predictors, and prognostic implications of PR interval prolongation in patients referred with suspected heart failure. METHODS AND RESULTS: Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included...
September 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28916721/loss-of-cardiac-carnitine-palmitoyltransferase-2-results-in-rapamycin-resistant-acetylation-independent-hypertrophy
#16
Andrea S Pereyra, Like Y Hasek, Kate L Harris, Alycia G Berman, Frederick W Damen, Craig J Goergen, Jessica M Ellis
Cardiac hypertrophy is closely linked to impaired fatty acid oxidation, but the molecular basis of this link is unclear. Here, we investigated the loss of an obligate enzyme in mitochondrial long-chain fatty acid oxidation, carnitine palmitoyltransferase 2 (CPT2), on muscle and heart structure, function, and molecular signatures in a muscle- and heart-specific CPT2-deficient mouse (Cpt2M-/-) model. CPT2 loss in heart and muscle reduced complete oxidation of long-chain fatty acids by 87% and 69%, respectively, without altering body weight, energy expenditure, respiratory quotient, or adiposity...
September 15, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28916479/dietary-nitrate-increases-vo2peak-and-performance-but-does-not-alter-ventilation-or-efficiency-in-patients-with-heart-failure-with-reduced-ejection-fraction
#17
Andrew R Coggan, Seth R Broadstreet, Kiran Mahmood, Deana Mikhalkova, Michael Madigan, Indra Bole, Soo Park, Joshua L Leibowitz, Ana Kadkhodayan, Deepak P Thomas, Dakkota Thies, Linda R Peterson
BACKGROUND: Patients with heart failure with reduced ejection fraction (HFrEF) exhibit lower efficiency, dyspnea, and diminished peak O2 uptake (VO2peak) during exercise. Dietary nitrate (NO3(-)), a source of nitric oxide (NO), has improved these measures in some studies of other populations. We determined the effects of acute NO3(-) ingestion on exercise responses in eight patients with HFrEF using a randomized, double-blind, placebo-controlled, crossover design. METHODS AND RESULTS: Plasma NO3(-), nitrite (NO2(-)), and breath NO were measured at multiple time points and respiratory gas exchange was determined during exercise after ingestion of beetroot juice containing or devoid of 11...
September 12, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28916243/feasibility-and-accuracy-of-automated-software-for-transthoracic-three-dimensional-left-ventricular-volume-and-function-analysis-comparisons-with-two-dimensional-echocardiography-three-dimensional-transthoracic-manual-method-and-cardiac-magnetic-resonance-imaging
#18
Gloria Tamborini, Concetta Piazzese, Roberto M Lang, Manuela Muratori, Elisa Chiorino, Massimo Mapelli, Laura Fusini, Sarah Ghulam Ali, Paola Gripari, Gianluca Pontone, Daniele Andreini, Mauro Pepi
BACKGROUND: Recently, a new automated software package (HeartModel) was developed to obtain three-dimensional (3D) left ventricular (LV) volumes using a model-based algorithm (MBA) with a "one-button" simple system and user-adjustable slider. The aims of this study were to verify the feasibility and accuracy of the MBA in comparison with other commonly used imaging techniques in a large unselected population, to evaluate possible accuracy improvements of free operator border adjustments or changes of the slider's default position, and to identify differences in method accuracy related to specific pathologies...
September 12, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#19
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28915508/preoperative-intraaortic-balloon-pump-improves-early-outcomes-following-high-risk-coronary-artery-bypass-graft-surgery-a-meta-analysis-of-randomized-trials-and-prospective-study-design
#20
Penelope P Rampersad, Jacob A Udell, Rami Zawi, Maral Ouzounian, Christopher B Overgaard, Vinoda Sharma, Vivek Rao, Michael E Farkouh, Vladimír Džavík
BACKGROUND: Despite widespread use, evidence to support preemptive intraaortic balloon pump (IABP) insertion for patients undergoing high-risk coronary artery bypass graft (CABG) surgery remains sparse, and in need of a well-defined clinical trial. To inform the design of a prospective trial, we sought to review outcomes in randomized controlled trials (RCTs) of anticipatory IABP use vs control in patients undergoing high-risk CABG through meta-analysis. The primary endpoint was all-cause mortality within 30 days of surgery...
September 15, 2017: Journal of Invasive Cardiology
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