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Advanced heart failure

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https://www.readbyqxmd.com/read/29667071/optimizing-cardiac-resynchronization-therapy-an-update-on-new-insights-and-advancements
#1
REVIEW
Adam Grimaldi, Eiran Z Gorodeski, John Rickard
PURPOSE OF REVIEW: This review focuses on the current advancements in optimizing patient response to cardiac resynchronization therapy (CRT). RECENT FINDINGS: It has been well known that not every patient will derive benefit from CRT, and of those that do, there are varying levels of response. Optimizing CRT begins well before device implant and involves appropriate patient selection and an understanding of the underlying substrate. After implant, there are different CRT device programming options that can be enabled to help overcome barriers as to why a patient may not respond...
April 17, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29667017/underestimated-prevalence-of-heart-failure-in-hospital-inpatients-a-comparison-of-icd-codes-and-discharge-letter-information
#2
Mathias Kaspar, Georg Fette, Gülmisal Güder, Lea Seidlmayer, Maximilian Ertl, Georg Dietrich, Helmut Greger, Frank Puppe, Stefan Störk
BACKGROUND: Heart failure is the predominant cause of hospitalization and amongst the leading causes of death in Germany. However, accurate estimates of prevalence and incidence are lacking. Reported figures originating from different information sources are compromised by factors like economic reasons or documentation quality. METHODS: We implemented a clinical data warehouse that integrates various information sources (structured parameters, plain text, data extracted by natural language processing) and enables reliable approximations to the real number of heart failure patients...
April 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29666178/causes-of-death-in-a-contemporary-adult-congenital-heart-disease-cohort
#3
Christopher Yu, Benjamin M Moore, Irina Kotchetkova, Rachael L Cordina, David S Celermajer
OBJECTIVE: The life expectancy of patients with congenital heart disease (CHD) has significantly improved with advances in their paediatric medical care. Mortality patterns are changing as a result. Our study aims to describe survival and causes of death in a contemporary cohort of adult patients with CHD. METHODS: We reviewed 3068 patients in our adult CHD database (age ≥16 years, seen at least once in our centre between 2000 and 2015), and documented the number and causes of death, via Australia's National Death Index...
April 17, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29666073/ventricular-assist-device-utilization-in-heart-transplant-candidates-nationwide-variability-and-impact-on-waitlist-outcomes
#4
Lauren K Truby, A Reshad Garan, Raymond C Givens, Koji Takeda, Hiroo Takayama, Pauline N Trinh, Melana Yuzefpolskaya, Maryjane A Farr, Yoshifumi Naka, Paolo C Colombo, Veli K Topkara
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVADs) have become a standard treatment choice in advanced heart failure patients. We hypothesized that practice patterns with regards to CF-LVAD utilization vary significantly among transplant centers and impact waitlist outcomes. METHODS AND RESULTS: The United Network for Organ Sharing registry was queried to identify adult patients who were waitlisted for heart transplantation (HT) between 2008 and 2015...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29664541/-50-years-of-heart-transplantations
#5
Carl Söderlund, Göran Rådegran
50 years have passed since the first human to human heart transplantation, performed by Christiaan Barnard in Cape Town December 3rd 1967. Over the years there has been a dramatic improvement in postoperative survival, mainly due to numerous diagnostic and therapeutic advances. Today, heart transplantation constitutes the treatment of choice among suitable patients with severe heart failure who worsen despite medical and surgical optimization. The world average 10-year survival has now reached more than 58 %...
April 12, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29662642/successful-retreatment-with-grazoprevir-and-elbasvir-for-patients-infected-with-hepatitis-c-virus-genotype-1b-who-discontinued-prior-treatment-with-ns5a-inhibitor-including-regimens-due-to-adverse-events
#6
Tatsuo Kanda, Shin Yasui, Masato Nakamura, Shingo Nakamoto, Koji Takahashi, Shuang Wu, Reina Sasaki, Yuki Haga, Sadahisa Ogasawara, Tomoko Saito, Kazufumi Kobayashi, Soichiro Kiyono, Yoshihiko Ooka, Eiichiro Suzuki, Tetsuhiro Chiba, Hitoshi Maruyama, Mitsuhiko Moriyama, Naoya Kato
Background: Sustained virologic response (SVR) by interferon and interferon-free treatment can results in the reduction of advanced liver fibrosis and the occurrence of hepatocellular carcinoma in patients infected with hepatitis C virus (HCV). Recent interferon-free treatment for HCV shortens the duration of treatment and leads to higher SVR rates, without any serious adverse events. However, it is important to retreat patients who have had treatment-failure with HCV non-structural protein 5A (NS5A) inhibitor-including regimens...
March 23, 2018: Oncotarget
https://www.readbyqxmd.com/read/29662512/prediction-of-sudden-death-in-elderly-patients-with-heart-failure
#7
REVIEW
Ana Ayesta, Helena Martínez-Sellés, Antonio Bayés de Luna, Manuel Martínez-Sellés
Most heart failure (HF) related mortality is due to sudden cardiac death (SCD) and worsening HF, particularly in the case of reduced ejection fraction. Predicting and preventing SCD is an important goal but most works include no or few patients with advanced age, and the prevention of SCD in elderly patients with HF is still controversial. A recent reduction in the annual rate of SCD has been recently described but it is not clear if this is also true in advanced age patients. Age is associated with SCD, although physicians frequently have the perception that elderly patients with HF die mainly of pump failure, underestimating the importance of SCD...
February 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29658862/progress-in-gene-therapy-for-chronic-heart-failure
#8
Zhi-Qiang Yin, Wan-Hong Xing
Chronic heart failure (CHF) is still the leading cause of morbidity and mortality worldwide, and carries with it large economic and social burdens. Although steady and substantial progress has been made in reducing mortality from heart failure using conventional treatments, novel pharmacologic and surgical interventions have not been effective in extending five year survival rates. Therefore, it is necessary to explore new therapies. Gene therapy was introduced in 1970s with the development of recombinant DNA technology...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29656903/improving-the-prognosis-of-patients-with-severely-decreased-glomerular-filtration-rate-ckd-g4-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#9
Kai-Uwe Eckardt, Nisha Bansal, Josef Coresh, Marie Evans, Morgan E Grams, Charles A Herzog, Matthew T James, Hiddo J L Heerspink, Carol A Pollock, Paul E Stevens, Manjula Kurella Tamura, Marcello A Tonelli, David C Wheeler, Wolfgang C Winkelmayer, Michael Cheung, Brenda R Hemmelgarn
Patients with severely decreased glomerular filtration rate (GFR) (i.e., chronic kidney disease [CKD] G4+) are at increased risk for kidney failure, cardiovascular disease (CVD) events (including heart failure), and death. However, little is known about the variability of outcomes and optimal therapeutic strategies, including initiation of kidney replacement therapy (KRT). Kidney Disease: Improving Global Outcomes (KDIGO) organized a Controversies Conference with an international expert group in December 2016 to address this gap in knowledge...
April 12, 2018: Kidney International
https://www.readbyqxmd.com/read/29655662/evaluation-of-low-intensity-anti-coagulation-with-a-fully-magnetically-levitated-centrifugal-flow-circulatory-pump-the-magentum-1-study
#10
Ivan Netuka, Peter Ivák, Zuzana Tučanová, Stanislav Gregor, Ondrej Szárszoi, Poornima Sood, Daniel Crandall, Jessica Rimsans, Jean Marie Connors, Mandeep R Mehra
BACKGROUND: The HeartMate 3 left ventricular assist system is engineered to avoid pump thrombosis, yet bleeding complications persist. We investigated the safety of low-intensity anti-coagulation in patients with the HeartMate 3. METHODS: The Minimal AnticoaGulation EvaluatioNTo aUgment heMocompatibility (MAGENTUM 1) pilot study is a prospective, single-arm study of low-intensity warfarin anti-coagulation in patients implanted with the HeartMate 3 pump. After standard warfarin anti-coagulation (international normalized ratio [INR] 2...
March 27, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29655525/predictive-value-of-liver-damage-for-severe-early-complications-and-survival-after-heart-transplantation-a-retrospective-analysis
#11
Pascal Lebray, Shaida Varnous, Alina Pascale, Philippe Leger, Charles Edouard Luyt, Vlad Ratziu, Mona Munteanu, Salima Ould Amar, Dominique Thabut, Jean Chastre, Alain Pavie, Thierry Poynard, Pascal Leprince
BACKGROUND: Hepatic dysfunction is often associated with advanced heart failure. Its impact on complications following heart transplantation is not well known. We studied the influence of preoperative hepatic dysfunction on the results of heart transplantation with a specific priority access for critical patients. METHODS: Consecutive heart transplantation patients were retrospectively analyzed at listing to detect predictive factors for early complications and survival following heart transplantation...
April 11, 2018: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29651826/new-percutaneous-interventions-in-heart-failure
#12
Elisabetta Moscarella, Salvatore Brugaletta, Manel Sabaté
Chronic heart failure (HF) is one of the main causes of mortality and morbidity worldwide and represents a growing challenge in interventional cardiology. Its prevalence is recently increasing due to the improvements in cardiac care with subsequent significant reduction in the HF acute mortality. HF may occur with either a reduced left ventricular ejection fraction (LVEF) (LVEF<40%, HFrEF) or a preserved EF (typically LVEF≥50%, HFpEF) indicative of diastolic dysfunction. Despite recent advances in drug therapies as well as in nonpharmacological strategies, including defibrillators, cardiac resynchronization therapy, LV assist devices (LVAD), mortality in HF remains high...
April 12, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29650709/machine-learning-methods-improve-prognostication-identify-clinically-distinct-phenotypes-and-detect-heterogeneity-in-response-to-therapy-in-a-large-cohort-of-heart-failure-patients
#13
Tariq Ahmad, Lars H Lund, Pooja Rao, Rohit Ghosh, Prashant Warier, Benjamin Vaccaro, Ulf Dahlström, Christopher M O'Connor, G Michael Felker, Nihar R Desai
BACKGROUND: Whereas heart failure (HF) is a complex clinical syndrome, conventional approaches to its management have treated it as a singular disease, leading to inadequate patient care and inefficient clinical trials. We hypothesized that applying advanced analytics to a large cohort of HF patients would improve prognostication of outcomes, identify distinct patient phenotypes, and detect heterogeneity in treatment response. METHODS AND RESULTS: The Swedish Heart Failure Registry is a nationwide registry collecting detailed demographic, clinical, laboratory, and medication data and linked to databases with outcome information...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29649405/economic-impact-of-early-inpatient-palliative-care-intervention-in-a-community-hospital-setting
#14
James Fitzpatrick, Matthew Mavissakalian, Tisha Luciani, Yijing Xu, Amber Mazurek
BACKGROUND: Inpatient palliative care programs have demonstrated financial benefit for the hospital and improved quality of care for patients with advanced disease. Previous studies on this subject have focused on comparisons between palliative and traditional care. The financial and clinical effects of early versus late palliative care intervention are less well documented. OBJECTIVE: The aims of this study are to review the financial and quality outcomes that early palliative care intervention has on appropriate inpatients in the community hospital setting...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649151/dna-methylation-and-histone-modification-in-hypertension
#15
REVIEW
Shaunrick Stoll, Charles Wang, Hongyu Qiu
Systemic hypertension, which eventually results in heart failure, renal failure or stroke, is a common chronic human disorder that particularly affects elders. Although many signaling pathways involved in the development of hypertension have been reported over the past decades, which has led to the implementation of a wide variety of anti-hypertensive therapies, one half of all hypertensive patients still do not have their blood pressure controlled. The frontier in understanding the molecular mechanisms underlying hypertension has now advanced to the level of epigenomics...
April 12, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29643259/cerebrovascular-accidents-during-mechanical-circulatory-support-new-predictors-of-ischemic-and-hemorrhagic-strokes-and-outcome
#16
Saef Izzy, Daniel B Rubin, Firas S Ahmed, Feras Akbik, Simone Renault, Katelyn W Sylvester, Henrikas Vaitkevicius, Jennifer A Smallwood, Michael M Givertz, Steven K Feske
BACKGROUND AND PURPOSE: Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality...
April 11, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29642755/successful-treatment-of-ventricular-arrhythmic-storm-with-percutaneous-coronary-intervention-and-catheter-ablation-in-a-patient-with-left-ventricular-assist-device
#17
Nihat Firat Sipahi, Arash Mehdiani, Diyar Saeed, Udo Boeken, Hisaki Makimoto, Artur Lichtenberg, Hannan Dalyanoglu
INTRODUCTION: Ventricular arrhythmias are common in patients with advanced heart failure, which may also persist after sufficient intensive therapy for heart failure even with a left ventricular assist device. Although most ventricular arrhythmias have no hemodynamic relevance during left ventricular assist device support, some patients suffer from right ventricular decompensation due to ventricular arrhythmias resulting in severe hemodynamic deterioration and poor clinical outcomes. METHODS: We describe herein an left ventricular assist device patient with refractory ventricular arrhythmic storm early after left ventricular assist device implantation...
April 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29629921/assessment-of-cardiac-thrombosis-in-patients-with-left-ventricular-assist-device-using-multidetector-cardiac-computed-tomography
#18
Chukwuemeka A Obi, Nicholas Chan, Monica G Rizkalla, John N Makaryus
: A 79-year-old man with nonischemic cardiomyopathy who underwent left ventricular assist device HeartMate II and automated implantable cardioverter defibrillator placement presented with recurrent refractory sustained ventricular tachycardia, elevated lactate dehydrogenase, and low haptoglobin. Echocardiography demonstrated no thrombosis; cardiac computed tomography showed patent inflow and outflow cannulas while detecting an irregularly shaped mass adherent to the left coronary cusp of the aortic valve, suggesting a thrombus...
April 7, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29629256/european-society-of-cardiology-proposed-diagnostic-echocardiographic-algorithm-in-elective-patients-with-clinical-suspicion-of-infective-endocarditis-diagnostic-yield-and-prognostic-implications-in-clinical-practice
#19
Andrea Barbieri, Francesca Mantovani, Roberta Lugli, Francesca Bursi, Matteo Fabbri, Ylenia Bartolacelli, Marcella Manicardi, Guglielmo Stefanelli, Cristina Mussini, Giuseppe Boriani
Background: Echocardiography plays a central role in diagnosing infective endocarditis (IE). Accordingly, the European Society of Cardiology (ESC) has proposed a diagnostic echocardiographic algorithm. However, new studies are still needed to evaluate the degree of implementation of these guidelines in clinical practice and their consequences on incidence and prognosis of IE. Aim: This study aims to investigate the diagnostic yield of the ESC proposed echocardiographic algorithm in patients with suspected IE...
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29628028/-disorders-associated-with-mild-cognitive-impairment-risk-factors-and-predictors
#20
Manuel Antón Jiménez, José Luis González Guerrero
Traditionally, cognitive impairment has been associated not only with ageing itself but also with concomitant comorbidities that interact in the disease continuum from the prodromic phases. Notable among these are delirium, nutritional alterations, balance and gait, infections and even a progressive incidence of neoplasms. However, with regard to diagnosis and staging, clinicians should perhaps remain especially alert to the possibility of pharmacological iatrogeny, which is not limited to psychopharmacological treatment...
June 2017: Revista Española de Geriatría y Gerontología
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