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Right heart failure

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https://www.readbyqxmd.com/read/28734918/rv-myocardial-strain-during-pre-load-augmentation-is-associated-with-exercise-capacity-in-patients-with-chronic-hf
#1
Kenya Kusunose, Hirotsugu Yamada, Susumu Nishio, Ayumi Ishii, Yukina Hirata, Hiromitsu Seno, Yoshihito Saijo, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata
OBJECTIVES: The aim of this study was to assess the relationship between right ventricular (RV) function during pre-load augmentation and exercise tolerance. BACKGROUND: Peak oxygen uptake (VO2) is a strong predictor of mortality in chronic heart failure. Cardiac function during pre-load augmentation is an important part of the phenomenon in the evaluation of exercise capacity. METHODS: We prospectively performed echocardiographic studies in 68 chronic heart failure patients with cardiopulmonary exercise testing (mean age 60 ± 12 years; 69% male)...
July 13, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28734444/systemic-artery-to-pulmonary-vein-fistula-after-right-upper-lobectomy-demonstrated-by-4-dimensional-flow-magnetic-resonance-imaging
#2
Antoine Legras, Arshid Azarine, Bastien Poitier, Emmanuel Messas, Françoise Le Pimpec-Barthes
Postoperative systemic artery to pulmonary vein fistula is very rare. In this report, we describe an exceptional condition of both intrapulmonary arteriovenous fistula and systemic artery to pulmonary vein fistula, involving all right hemithoracic systemic arteries, inducing left-to-left shunt. This condition was responsible for heart failure, 24 years after a right upper lobectomy for inflammatory tumor. Investigations included computed tomographic angiography, arteriography, and four-dimensional flow magnetic resonance imaging...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28734440/use-of-mechanical-circulatory-support-in-isolated-right-heart-failure-a-bridge-to-transplantation
#3
Daniel J Beissel, Brian F Birnbaum, Aliessa P Barnes, James E O'Brien, Elizabeth M Turk, James D St Louis
Acute myocarditis may lead to left ventricular dysfunction and subsequent need for cardiac transplantation. We describe a 15-month-old child who presented with right heart failure of unclear cause. Echocardiography showed normal left ventricular function; however, right ventricular function was markedly reduced. The patient required extracorporeal membrane oxygenation followed by placement of a right-sided Berlin EXCOR ventricular assist device. There was little recovery, and the child underwent cardiac transplantation...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28734437/two-pumps-for-single-ventricle-mechanical-support-for-establishment-of-biventricular-circulation
#4
Stanislav Ovroutski, Oliver Miera, Thomas Krabatsch, Felix Berger, Joachim Photiadis, Evgenii Potapov
A 31-year-old patient with a univentricular heart and double-inlet left ventricle, moderate pulmonary stenosis, and severe mitral valve regurgitation experienced irreversible heart failure after mitral valve replacement. "Biventricular" mechanical circulatory support was initiated. The systemic circulation was supported using the HeartWare ventricular assist device (HVAD) (HeartWare, Framingham, MA) pump in the usual manner. The second pump was inserted into the right atrium and connected to the pulmonary artery after closure of the pulmonary valve and atrial separation...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28734084/thrombolysis-for-pulmonary-embolism-using-the-superficial-veins-of-the-upper-extremity
#5
Joseph Kusick, Judd Salamat, Kintur Sanghvi
This report describes a novel approach of accessing the superficial veins of the upper extremity for the treatment of pulmonary emboli (PE) with an ultrasound enhanced thrombolytic infusion catheter. In a patient suffering from saddle PE and impending right heart failure, separate basilic and cephalic venous access sites in the right arm were utilized to insert EKOS EndoWave Infusion Catheter (EKOS Corporation, Bothell, WA) insertion in each pulmonary artery (PA). This technique could be advantageous, particularly for patients at high risk for access site complications and those unable to lie supine for prolonged duration of infusion therapy...
July 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28734025/dual-site-right-ventricular-pacing-in-patients-undergoing-cardiac-resynchronization-therapy-results-of-a-multicentre-propensity-matched-analysis
#6
Rui Providencia, Sergio Barra, Nikolaos Papageorgiou, Adam Ioannou, Dominic Rogers, Tanakal Wongwarawipat, Debbie Falconer, Rudolf Duehmke, Martina Colicchia, Girish Babu, Oliver R Segal, Simon Sporton, Mehul Dhinoja, Syed Ahsan, Vivienne Ezzat, Edward Rowland, Martin Lowe, Pier D Lambiase, Sharad Agarwal, Anthony W Chow
BACKGROUND: Dual RV has been proposed as an alternative for patients with heart failure undergoing cardiac resynchronization therapy (CRT) with a failure to deliver a coronary sinus (CS) lead. Only short-term haemodynamic and echocardiographic results of Dual RV are available. We aimed to assess the long-term results of Dual-site right ventricular pacing (Dual RV) and its impact on survival. METHODS: Multicentre retrospective assessment of all CRT implants during a 12-year period...
July 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28733849/novel-pacing-strategies-for-heart-failure-management
#7
REVIEW
Jordan S Leyton-Mange, Theofanie Mela
Cardiac resynchronization therapy has emerged as the gold standard for heart failure patients with left ventricular systolic dysfunction and electrical dyssynchrony from an intrinsic intraventricular conduction delay or right ventricular pacing. However, the limits imposed by the coronary sinus venous anatomy restrict the applicability of the technology for many potential recipients. Furthermore, conventional resynchronization, by virtue of utilizing a single site of epicardial origin for left ventricular activation, is non-physiological...
August 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28728933/predictors-of-mortality-in-pulmonary-sarcoidosis
#8
Gamze Kirkil, Elyse E Lower, Robert P Baughman
OBJECTIVES: To assess the prognostic strength of factors in predicting respiratory death in a large cohort of sarcoidosis patients with at least eight years' follow-up. METHODS: We collected age, sex, self-declared race, time of death, spirometry, diffusing capacity for carbon monoxide, chest x-ray stage, extent of fibrosis on high resolution computer tomography (HRCT), and presence of pre-capillary pulmonary hypertension (PH). The gender, age, physiology (GAP) index and Walsh's criteria for high versus low risk were calculated...
July 17, 2017: Chest
https://www.readbyqxmd.com/read/28728923/ruptured-sinus-of-valsalva-aneurysm-causing-acute-right-heart-and-hepatorenal-failure-requiring-urgent-surgery
#9
Benjamin Swinson, Robert Grant, Ekta Paw, Raibhan Yadav, Anand Iyer
A sinus of Valsalva aneurysm is a rare cardiac anomaly that may be congenital or acquired. Very rarely, they present with acute symptoms as a result of rupture into the cardiac chamber. If left untreated, they almost always result in deteriorating cardiac function. We report a patient presenting with acute right heart failure and hepatorenal syndrome requiring urgent surgery and double patch repair.
May 29, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28728723/surgical-treatment-of-heart-failure
#10
REVIEW
Robert S D Higgins, Ahmet Kilic, Daniel G Tang
More than 5 million Americans suffer from heart failure and more than 250,000 die annually. Cardiac surgery, as applied to advanced heart failure, has evolved significantly in the past 50 years. Current therapeutic interventions are focused on the appropriate assessment of myocardial dysfunction as a means to select the right patient for the appropriate procedure using state-of-the-art myocardial viability testing and metabolic testing to determine candidacy for conventional interventions, mechanical devices, or transplant...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728692/magnetic-resonance-in-transthyretin%C3%A2-cardiac-amyloidosis
#11
Ana Martinez-Naharro, Thomas A Treibel, Amna Abdel-Gadir, Heerajnarain Bulluck, Giulia Zumbo, Daniel S Knight, Tushar Kotecha, Rohin Francis, David F Hutt, Tamer Rezk, Stefania Rosmini, Candida C Quarta, Carol J Whelan, Peter Kellman, Julian D Gillmore, James C Moon, Philip N Hawkins, Marianna Fontana
BACKGROUND: Cardiac transthyretin amyloidosis (ATTR) is an increasingly recognized cause of heart failure. Cardiac magnetic resonance (CMR), with late gadolinium enhancement (LGE) and T1 mapping, is emerging as a reference standard for diagnosis and characterization of cardiac amyloidosis. OBJECTIVES: The authors used CMR with extracellular volume fraction (ECV) measurement to characterize cardiac involvement in relation to outcome in ATTR. METHODS: Subjects comprised 263 patients with cardiac ATTR corroborated by grade 2 to 3 (99m)Tc-DPD ((99m)Tc-3,3-diphosphono-1,2-propanodicarboxylic acid) cardiac uptake, 17 with suspected cardiac ATTR (grade 1 (99m)Tc-DPD), and 12 asymptomatic individuals with amyloidogenic transthyretin (TTR) mutations...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28720600/is-the-mechanism-of-re-expansion-pulmonary-oedema-in-a-heart-lung-interaction
#12
Candy Masego Mokotedi, Martin Balik
The mechanism of re-expansion pulmonary oedema (Re-PE) is unclear. There are multiple variables in play when evaluating the response to evacuation of pleural fluid. We present an educational case of a critically ill patient admitted for respiratory failure who was fully dependent on ventricular pacing set at a constant rate throughout the episode of Re-PE. The transthoracic echocardiography (TTE) showed an ejection fraction of 38%, moderate mitral regurgitation (MR), mildly dilated right ventricle and moderate pulmonary hypertension...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716832/mechanical-circulatory-support-devices-for-acute-right-ventricular-failure
#13
REVIEW
Navin K Kapur, Michele L Esposito, Yousef Bader, Kevin J Morine, Michael S Kiernan, Duc Thinh Pham, Daniel Burkhoff
Right ventricular (RV) failure remains a major cause of global morbidity and mortality for patients with advanced heart failure, pulmonary hypertension, or acute myocardial infarction and after major cardiac surgery. Over the past 2 decades, percutaneously delivered acute mechanical circulatory support pumps specifically designed to support RV failure have been introduced into clinical practice. RV acute mechanical circulatory support now represents an important step in the management of RV failure and provides an opportunity to rapidly stabilize patients with cardiogenic shock involving the RV...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28714262/baroreflex-mediated-sympathetic-overactivation-induced-by-mental-stress-in-post-traumatic-stress-disorder-depends-on-the-type-of-stressor
#14
Luiz Eduardo Virgilio Silva, Pedro Lourenço Katayama
Sympathetic overactivation has long been recognized as a deleterious condition, involved in the physiopathology of several diseases. The overactivity of sympathetic nervous system (SNS) may be the consequence of different conditions and an intriguing question that still remains is whether diseases, such as hypertension and heart failure, are induced by increased SNS or increased SNS is a consequence of the disease progression. This article is protected by copyright. All rights reserved.
July 17, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28714070/a-reduction-in-sk-channels-contributes-to-increased-activity-of-hypothalamic-magnocellular-neurons-during-heart-failure
#15
H C Ferreira-Neto, V Biancardi, J E Stern
Small conductance Ca(2+) -activated K(+) channels (SK) play an important role in regulating MNCs activity and hormone release from the posterior pituitary. Moreover, an enhanced SK activity contributes to MNCs' adaptive responses to a physiological challenge, such as lactation. Still, whether changes in SK function/expression contribute to exacerbated MNCs activity during diseases like heart failure (HF), remains unknown. Here, we used a combination of patch-clamp electrophysiology, confocal Ca(2+) imaging and molecular biology in a rat model of ischemic HF...
July 17, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28712955/clinical-impact-of-changes-in-hemodynamic-indices-of-contractile-function-during-treatment-of-acute-decompensated-heart-failure
#16
Kenneth C Bilchick, Eliany Mejia-Lopez, Peter McCullough, Khadijah Breathett, Jamie L Kennedy, Jose Tallaj, James Bergin, Salpy Pamboukian, Mohammad Abuannadi, Sula Mazimba
BACKGROUND: The objective was to determine the impact of improving right ventricular versus left ventricular stroke work indices (RVSWI v. LVSWI) during therapy for acute decompensated heart failure (ADHF). METHODS AND RESULTS: Cox proportional hazards regression and logistic regression was used to analyze key factors associated with outcomes in 175 patients (age 56.7 ± 13.6 years, 29.1% female) with hemodynamic data from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial...
July 13, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#17
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995-2015. Nineteen patients were switched from tacrolimus(n=15) or cyclosporin(n=4) to everolimus(n=4) or sirolimus(n=15) due to nephrotoxicity(n=5), malignancy(n=8), EBV viremia/reactive plasmacytic changes(n=5) and immune hemolytic anemia(n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28707730/complement-and-contact-system-activation-in-acute-congestive-heart-failure-patients
#18
Chiara Suffritti, Eleonora Tobaldini, Riccardo Schiavon, Silvia Strada, Lorena Maggioni, Satish Mehta, Giulia Sandrone, Edgar Toschi-Dias, Marco Cicardi, Nicola Montano
BACKGROUND: Recent experimental data indicate a pathogenic role of complement activation in congestive heart failure (CHF). Aim of this study was to evaluate contact and complement systems activation in patients hospitalized for an acute episode of CHF. METHODS AND RESULTS: 42 of 80 consecutive patients admitted at our hospital with confirmed diagnosis of acute CHF were enrolled. They underwent blood sampling within 24 hours from admission (T0) and at clinical stability (T1)...
July 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28706871/tricuspid-valve-regurgitation-after-heart-transplantation
#19
Murray H Kwon, Richard J Shemin
Tricuspid valve regurgitation (TVR) in the orthotopic heart transplant (OHT) recipient is quite common and has varied clinical sequelae. In its severest forms, it can lead to right-sided failure symptoms indistinguishable from that seen in native heart TVR disease. While certain implantation techniques are widely recognized to reduce the risk of TVR in the cardiac allograft, concomitant tricuspid annuloplasty, while having advocates, is not currently accepted as a routinely established adjunct. Decisions to surgically correct TVR in the OHT recipient must be made carefully, as certain clinical scenarios have high risk of failure...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28706868/tricuspid-valve-endocarditis
#20
Syed T Hussain, James Witten, Nabin K Shrestha, Eugene H Blackstone, Gösta B Pettersson
Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5-10% of cases of IE. Ninety percent of RSIE involves the tricuspid valve (TV). Given the relatively small numbers of TVIE cases operated on at most institutions, the purpose of this review is to highlight and discuss the current understanding of IE involving the TV. RSIE and TVIE are strongly associated with intravenous drug use (IVDU), although pacemaker leads, defibrillator leads and vascular access for dialysis are also major risk factors...
May 2017: Annals of Cardiothoracic Surgery
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