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https://www.readbyqxmd.com/read/28828566/communication-in-heart-failure-and-palliative-care
#1
REVIEW
Joshua Hauser
Communicating difficult information is an essential skill for clinicians of every specialty. The clinical complexity of the heart failure disease process lends itself to important opportunities to determine patient preferences about medical decisions and share information about prognosis. Nevertheless, traditionally most communication between clinicians and patients with heart failure has focused primarily on pathophysiology and treatment options. Studies indicate that patients and families wish to engage with their cardiologists in advance care planning and, when appropriate, end-of-life decision-making...
August 21, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28827063/beyond-simple-planning-existential-dimensions-of-conversations-with-patients-at-risk-of-dying-from-heart-failure
#2
Valerie Schulz, Allison Crombeen, Denise Marshall, Joshua Shadd, Kori LaDonna, Lorelei Lingard
INTRODUCTION: Despite the recent promotion of communication guides to improve decision-making with patients nearing the end of their lives, these conversations remain challenging. Deeper and more comprehensive understanding of communication barriers that undermine discussions and decisions with patients at risk of dying from heart failure (HF) are vital for informing communication in healthcare. OBJECTIVES: To explore experiences and perspectives of patients with advanced HF, their caregivers and providers, regarding conversations for patients at risk of dying from HF...
August 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28826226/patterns-of-palliative-care-referral-in-patients-admitted-with-heart-failure-requiring-mechanical-ventilation
#3
Katie J Wiskar, Leo Anthony Celi, Robert C McDermid, Keith R Walley, James A Russell, John H Boyd, Barret Rush
BACKGROUND: Palliative care is recommended for advanced heart failure (HF) by several major societies, though prior studies indicate that it is underutilized. AIM: To investigate patterns of palliative care referral for patients admitted with HF exacerbations, as well as to examine patient and hospital factors associated with different rates of palliative care referral. DESIGN: Retrospective nationwide cohort analysis utilizing the National Inpatient Sample from 2006 to 2012...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28822745/discordant-perceptions-of-prognosis-and-treatment-options-between-physicians-and-patients-with-advanced-heart-failure
#4
Amrut V Ambardekar, Jennifer T Thibodeau, Adam D DeVore, Michelle M Kittleson, Rhondalyn C Forde-McLean, Maryse Palardy, Maria M Mountis, Linda Cadaret, Jeffrey J Teuteberg, Salpy V Pamboukian, Rongbing Xie, Lynne W Stevenson, Garrick C Stewart
OBJECTIVES: This study assessed patient and physician perceptions of heart failure (HF) disease severity and treatment options. BACKGROUND: The prognosis for ambulatory patients with advanced HF on medical therapy is uncertain, yet has important implications for decision making regarding transplantation and left ventricular assist device (LVAD) placement. METHODS: Ambulatory patients with advanced HF (New York Heart Association functional class III to IV, Interagency Registry for Mechanically Assisted Circulatory Support profiles 4 to 7) on optimized medical therapy were enrolled across 11 centers...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28822743/medical-management-of-patients-with-a%C3%A2-left-ventricular-assist-device-for-the%C3%A2-non-left-ventricular-assist-device%C3%A2-specialist
#5
REVIEW
Adam D DeVore, Priyesh A Patel, Chetan B Patel
More than 2,400 continuous-flow left ventricular assist devices (LVADs) are implanted each year in the United States alone. Both the number of patients living with LVADs and the life expectancy of these patients are increasing. As a result, patients with LVADs are increasingly encountered by non-LVAD specialists who do not have training in managing advanced heart failure for general medical care, cardiovascular procedures, and other subspecialty care. An understanding of the initial evaluation and management of patients with LVADs is now an essential skill for many health care providers...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28821988/presentation-and-management-of-symptomatic-central-bone-cement-embolization
#6
Ahmed Samir Barakat, Tamer Owais, Mohamed Alhashash, Mootaz Shousha, Hesham El Saghir, Bernward Lauer, Heinrich Boehm
BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...
August 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28821391/clinical-decision-support-to-effeciently-identify-patients-eligible-for-advanced-heart-failure-therapies
#7
R Scott Evans, Abdallah G Kfoury, Benjamin D Horne, James F Lloyd, Jose Benuzillo, Kismet D Rasmusson, Colleen Roberts, Donald L Lappé
BACKGROUND: Patients who need and receive timely advanced heart failure (HF) therapies have better long-term survival. However, many of these patients are not identified and referred as soon as possible. METHODS: A clinical decision support (CDS) application sent secure email notifications to HF patients' providers when they transitioned to advanced disease. Patients identified with CDS in 2015 were compared to control patients from 2013-14. Kaplan-Meier methods and Cox regression were used in this intention-to-treat analysis to compare differences between visits to specialized heart facilities and survival...
August 15, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28820968/reduced-activin-receptor-like-kinase-1-activity-promotes-cardiac-fibrosis-in-heart-failure
#8
Kevin J Morine, Xiaoying Qiao, Vikram Paruchuri, Mark J Aronovitz, Emily E Mackey, Lyanne Buiten, Jonathan Levine, Keshan Ughreja, Prerna Nepali, Robert M Blanton, S Paul Oh, Richard H Karas, Navin K Kapur
INTRODUCTION: Activin receptor-like kinase 1 (ALK1) mediates signaling via the transforming growth factor beta-1 (TGFβ1), a pro-fibrogenic cytokine. No studies have defined a role for ALK1 in heart failure. HYPOTHESIS: We tested the hypothesis that reduced ALK1 expression promotes maladaptive cardiac remodeling in heart failure. METHODS AND RESULTS: In patients with advanced heart failure referred for left ventricular (LV) assist device implantation, LV Alk1 mRNA and protein levels were lower than control LV obtained from patients without heart failure...
July 18, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28820558/young-patient-with-advanced-heart-failure-no-longer-a-candidate-for-heart-transplantation-after-mitraclip%C3%A3-%C3%A2-procedure
#9
Cosmo Godino, Andrea Scotti, Eustachio Agricola, Carlo A Pivato, Mauro Chiarito, Stefano Stella, Massimo Maccherini, Alberto Margonato, Antonio Colombo
In Europe, mitral regurgitation (MR) is the second most common form of valvular heart disease requiring surgical treatment. The case is presented of a 36-year-old woman with end-stage heart failure secondary to chemotherapy-induced cardiotoxicity, complicated by severe MR. She was listed for heart transplantation and underwent percutaneous MitraClip® implantation in order to preclude further clinical deterioration while awaiting a suitable donor. The one-year follow-up showed a strong improvement of symptoms and mostly reverse left ventricular remodelling, with consequent removal from the heart transplantation list...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28817484/levosimendan-in-acute-and-advanced-heart-failure-an-appraisal-of-the-clinical-database-and-evaluation-of-its-therapeutic-applications
#10
J Altenberger, F Gustafsson, V-P Harjola, K Karason, D Kindgen-Milles, M Kivikko, G Malfatto, Z Papp, J Parissis, P Pollesello, G Pölzl, C Tschöpe
The use of inotropes for correcting haemodynamic dysfunction in patients with congestive heart failure has been described over many decades. However, negative or insufficient data have been collected regarding the effects of cardiac glycosides, catecholamines and phosphodiesterase inhibitors on quality of life and survival. More recently, the calcium sensitizer and potassium channel-opener levosimendan has been proposed as a safer inodilator than traditional agents in some heart failure settings, such as Advanced Heart Failure...
August 15, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28816774/practitioner-gender-and-quality-of-care-in-ambulatory-cardiology-practices-a-report-from-the-national-cardiovascular-data-practice-innovation-and-clinical-excellence-pinnacle-registry
#11
Dipti Gupta, Fengming Tang, Frederick A Masoudi, Philip G Jones, Paul S Chan, Stacie L Daugherty
BACKGROUND: Some studies suggest that female practitioners are more likely to provide guideline-concordant care than male practitioners; however, little is known about the role of practitioner gender in cardiology. OBJECTIVE: The aim of the study was to measure the association between practitioner gender and adherence to the cardiovascular performance measures in the American College of Cardiology's ambulatory Practice Innovation and Clinical Excellence Registry...
August 15, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28816094/theories-of-health-care-decision-making-at-the-end-of-life-a-meta-ethnography
#12
Kyounghae Kim, Katherine Heinze, Jiayun Xu, Melissa Kurtz, Hyunjeong Park, Megan Foradori, Marie T Nolan
The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015...
August 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28814664/pulmonary-arterial-hypertension-treatment-with-carvedilol-for-heart-failure-a-randomized-controlled-trial
#13
Samar Farha, Didem Saygin, Margaret M Park, Hoi I Cheong, Kewal Asosingh, Suzy Aa Comhair, Olivia R Stephens, Emir C Roach, Jacqueline Sharp, Kristin B Highland, Frank P DiFilippo, Donald R Neumann, W H Wilson Tang, Serpil C Erzurum
BACKGROUND: Right-sided heart failure is the leading cause of death in pulmonary arterial hypertension (PAH). Similar to left heart failure, sympathetic overactivation and β-adrenoreceptor (βAR) abnormalities are found in PAH. Based on successful therapy of left heart failure with β-blockade, the safety and benefits of the nonselective β-blocker/vasodilator carvedilol were evaluated in PAH. METHODS: PAH Treatment with Carvedilol for Heart Failure (PAHTCH) is a single-center, double-blind, randomized, controlled trial...
August 17, 2017: JCI Insight
https://www.readbyqxmd.com/read/28814264/left-ventricular-contractile-reserve-by-stress-echocardiography-as-a-predictor-of-response-to-cardiac-resynchronization-therapy-in-heart-failure-a-systematic-review-and-meta-analysis
#14
Quirino Ciampi, Clara Carpeggiani, Claudio Michelassi, Bruno Villari, Eugenio Picano
BACKGROUND: The presence of left ventricular contractile reserve (LVCR) during stress echo (SE) may provide favorable response to cardiac resynchronization therapy (CRT) in heart failure patients. The aim of the study was to perform a meta-analysis of available SE data in this set of patients. METHODS: From a Pubmed and Advance Google Scholar database web based search scan up to December 2016, we initially identified 5906 records. From this initial set, we removed that did not include SE and duplicate studies...
August 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28812262/systolic-dysfunction-in-infarcted-mice-does-not-necessarily-lead-to-heart-failure-need-to-refine-preclinical-models
#15
María Villalba-Orero, Marina López-Olañeta, Pablo García-Pavía, Enrique Lara-Pezzi
Heart failure (HF) is a major cause of death and hospitalization worldwide. Despite advances in reducing mortality, prognosis remains poor and prevalence has reached epidemic proportions. The limitations of available preclinical models represent a major hurdle in the development of new therapies. Myocardial infarction (MI) is a main cause of HF in humans, and mouse models of MI are often used to study HF mechanisms and experimental treatments. We investigated whether MI in mice constitutes an appropriate model of HF...
August 15, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#16
Enrica Fung, Tara I Chang, Glenn M Chertow, I-Chun Thomas, Steven M Asch, Manjula Kurella Tamura
BACKGROUND: Clinical practice guidelines recommend referral to nephrology when estimated glomerular filtration rate (eGFR) decreases to <30mL/min/1.73m(2); however, evidence for benefits of nephrology care are mixed. STUDY DESIGN: Observational cohort using landmark analysis. SETTINGS & PARTICIPANTS: A national cohort of veterans with advanced chronic kidney disease, defined as an outpatient eGFR≤30mL/min/1.73m(2) for January 1, 2010, through December 31, 2010, and a prior eGFR<60mL/min/1...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28809384/the-impact-of-cholecystectomy-after-endoscopic-sphincterotomy-for-complicated-gallstone-disease
#17
B Joseph Elmunzer, Mohamed Noureldin, Katherine A Morgan, David B Adams, Gregory A Coté, Akbar K Waljee
OBJECTIVES: Cholecystectomy after endoscopic sphincterotomy (ES) is associated with improved outcomes compared to ES alone, however randomized trials have included mainly fit surgical candidates. Our objective was to assess the impact of cholecystectomy after ES among elderly patients, in whom the perceived risks of surgery may be increased and the prevailing bias may be to defer cholecystectomy. METHODS: We performed adjusted analyses comparing clinical outcomes in patients ≥65 years of age who did and did not undergo follow-up cholecystectomy after endoscopic sphincterotomy for choledocholithiasis, ascending cholangitis, or gallstone pancreatitis...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28807706/the-relationship-between-psychological-symptoms-and-ventricular-assist-device-implantation
#18
Himali Weerahandi, Nathan Goldstein, Laura P Gelfman, Ulrich Jorde, James N Kirkpatrick, Edith Meyerson, Judith Marble, Yoshifumi Naka, Sean Pinney, Mark S Slaughter, Emilia Bagiella, Deborah D Ascheim
CONTEXT: Ventricular assist devices (VADs) improve quality of life in advanced heart failure (HF) patients, but there are little data exploring psychological symptoms in this population. OBJECTIVE: This study examined the prevalence of psychiatric symptoms and disease over time in VAD patients. METHODS: This prospective multicenter cohort study enrolled patients immediately before or after VAD implant and followed them up to forty-eight weeks...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28805234/prognostic-factors-for-mortality-due-to-pneumonia-among-adults-from-different-age-groups-in-singapore-and-mortality-predictions-based-on-psi-and-curb-65
#19
Zoe Xz Zhang, Yang Yong, Wan C Tan, Liang Shen, Han Seong Ng, Kok Yong Fong
INTRODUCTION: Pneumonia is associated with considerable mortality. However, the information on age-specific prognostic factors for death from pneumonia is limited. METHODS: Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years; 65-84 years; and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28805198/severe-reversible-hypocalcemic-cardiomyopathy-diagnosed-36-years-after-subtotal-thyroidectomy-a-case-report
#20
Waldemar Elikowski, Małgorzata Małek-Elikowska, Patrycja Lachowska-Kotowska
Chronic hypocalcemia, irrespectively of its etiology, can lead to severe impairment of the left ventricular (LV) contractility manifesting as dilated cardiomyopathy, usually defined as hypocalcemic cardiomyopathy (hypocaCM). This rarely diagnosed type of heart failure (HF), can be completely reversible, when treated properly with calcium and vitamin D supplementation or, in some subjects, with human recombinant parathormone. A CASE REPORT: The authors present a case of a 60-year-old male admitted with advanced pulmonary congestion, recurrent pulmonary edema and pleural effusion...
July 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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