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Heart failure, cardiac transplant,

Riccardo Toninato, Silvia Scuri, Vincenzo Tarzia, Gino Gerosa, Francesca M Susin
PURPOSE: The gold standard therapy for patients with advanced heart failure is heart transplant. The gap between donors and patients in waiting lists promoted the development of circulatory support devices, such as the total artificial heart (TAH). Focusing on in vitro tests performed with CardioWest™ TAH (CW) driven by the SynCardia Freedom® portable driver (FD) the present study goals are: i) prove the reliability of a hydraulic circuit used as patient simulator to replicate a quasi-physiological scenario for various hydrodynamic conditions, ii) investigate the hydrodynamic performance of the CW FD, iii) help clinicians in possible interpretation of clinical cases outcomes...
October 15, 2016: International Journal of Artificial Organs
Sven Reek
PURPOSE OF REVIEW: The wearable cardioverter-defibrillator has been available for over a decade. In recent years, the device has been prescribed increasingly for a wide range of indications. The purpose of this review is to describe the technical and clinical aspects of the wearable cardioverter-defibrillator. The available literature on safety, efficacy and cost-effectiveness is reviewed, and indications for use will be discussed. RECENT FINDINGS: The wearable cardioverter-defibrillator has been used successfully in more than 100 000 patients for a variety of indications...
October 15, 2016: Current Opinion in Cardiology
Priccila Zuchinali, Gabriela C Souza, Maurício Pimentel, Diego Chemello, André Zimerman, Vanessa Giaretta, Joyce Salamoni, Bianca Fracasso, Leandro I Zimerman, Luis E Rohde
Importance: The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. Objective: To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Design, Setting, and Participants: Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital...
October 17, 2016: JAMA Internal Medicine
James Wever-Pinzon, Craig H Selzman, Greg Stoddard, Omar Wever-Pinzon, Anna Catino, Abdallah G Kfoury, Nikolaos A Diakos, Bruce B Reid, Stephen McKellar, Michael Bonios, Antigone Koliopoulou, Deborah Budge, Aaron Kelkhoff, Josef Stehlik, James C Fang, Stavros G Drakos
BACKGROUND: Small-scale studies focused mainly on nonischemic cardiomyopathy (NICM) have shown that a subset of left ventricular assist device (LVAD) patients can achieve significant improvement of their native heart function, but the impact of ischemic cardiomyopathy (ICM) has not been specifically investigated. Many patients with acute myocardial infarction are discharged from their index hospitalization without heart failure (HF), only to return much later with overt HF syndrome, mainly caused by chronic remodeling of the noninfarcted region of the myocardium...
October 18, 2016: Journal of the American College of Cardiology
Liming Wang, L Zhu, R Luan, L Wang, J Fu, X Wang, L Sui
Dilated cardiomyopathy (DCM) is characterized by ventricular dilatation, and it is a common cause of heart failure and cardiac transplantation. This study aimed to explore potential DCM-related genes and their underlying regulatory mechanism using methods of bioinformatics. The gene expression profiles of GSE3586 were downloaded from Gene Expression Omnibus database, including 15 normal samples and 13 DCM samples. The differentially expressed genes (DEGs) were identified between normal and DCM samples using Limma package in R language...
October 10, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
Denise C Joffe, Thomas K Jones, Mark Reisman, Elizabeth Perpetua, Yuk Law, Andreas Schuler, G Burkhard Mackensen
We present the primary report of a paediatric patient who had placement of the MitraClip device for severe functional mitral regurgitation. The patient was a 14-year-old boy with symptomatic end-stage non-compaction type cardiomyopathy secondary to a mitochondrial cytopathy. He had severe mitral regurgitation, tricuspid valve regurgitation, a severely dilated LV with apical non-compaction, severe LV dysfunction and severe pulmonary hypertension. Despite optimal medical therapy he developed progressive symptoms of congestive heart failure and he was not a candidate for an assist device or cardiac transplantation...
October 10, 2016: EuroIntervention
Carola Hedberg-Oldfors, Emma Glamuzina, Peter Ruygrok, Lisa J Anderson, Perry Elliott, Oliver Watkinson, Chris Occleshaw, Malcolm Abernathy, Clinton Turner, Nicola Kingston, Elaine Murphy, Anders Oldfors
We describe a new type of cardiomyopathy caused by a mutation in the glycogenin-1 gene (GYG1). Three unrelated male patients aged 34 to 52 years with cardiomyopathy and abnormal glycogen storage on endomyocardial biopsy were homozygous for the missense mutation p.Asp102His in GYG1. The mutated glycogenin-1 protein was expressed in cardiac tissue but had lost its ability to autoglucosylate as demonstrated by an in vitro assay and western blot analysis. It was therefore unable to form the primer for normal glycogen synthesis...
October 7, 2016: Journal of Inherited Metabolic Disease
Dipesh K Shah, Salil V Deo, Andrew D Althouse, Jeffery J Teuteberg, Soon J Park, Robert L Kormos, Harold M Burkhart, Victor O Morell
BACKGROUND: Adults with congenital heart disease may present with end-stage heart failure necessitating orthotopic heart transplant (OHT). We sought to review the United Network for Organ Sharing (UNOS) experience with this unique cohort focusing on surgical outcomes and survival. METHODS: From the UNOS registry, 737 adult congenital heart disease recipients (ACHDR) out of 26,993 OHT patients (2.7%) who underwent OHT were studied to analyze early and late outcomes and compared to non-congenital recipients (NCR) over a 15-year period (2000-2014)...
October 5, 2016: Journal of Cardiac Surgery
Jose V Venero, Mark Doyle, Moneal Shah, Vikas K Rathi, June A Yamrozik, Ronald B Williams, Diane A Vido, Geetha Rayarao, Raymond Benza, Srinivas Murali, Jerry Glass, Peter Olson, George Sokos, Robert W W Biederman
BACKGROUND: Patients with newly diagnosed dilated cardiomyopathy (DCM) and advanced heart failure have a very high morbidity and mortality with an unpredictable clinical course. We investigated the role of cardiovascular magnetic resonance (CMR) imaging using late gadolinium enhancement (LGE) in this cohort of high-risk patients. We hypothesized that LGE has high prognostic value in primary DCM patients referred for possible transplantation/left ventricular assist device (LVAD) consideration...
December 2015: ESC Heart Failure
Francisco González-Vílchez, Javier Segovia Cubero, Luis Almenar, María G Crespo-Leiro, José M Arizón, Iago Sousa, Juan Delgado, Eulalia Roig, José Manuel Sobrino, José González-Costello
INTRODUCTION AND OBJECTIVES: The present article reports the characteristics and results of heart transplants in Spain since this therapeutic modality was first used in May 1984. METHODS: We describe the main features of recipients, donors, surgical procedures, and results of all heart transplants performed in Spain until December 31, 2015. RESULTS: A total of 299 cardiac transplants were performed in 2015, with the whole series comprising 7588 procedures...
October 1, 2016: Revista Española de Cardiología
Joseph G Rogers
Donor heart allocation in the United States has not evolved in concert with changes in the characteristics of patients on the waiting list or evolution in technology. Data showing the growing population of patients with advanced heart failure coupled with the relatively fixed number of cardiac donors and regional access disparities motivated the United Network for Organ Sharing (UNOS) Thoracic Committee to reexamine candidate prioritization and broader organ sharing. The resultant proposed policy change stratifies patients in a more granular manner based primarily on wait-list mortality and is designed to expand the geographic boundaries to permit greater access to donor hearts for the most critically ill patients awaiting transplant...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Susanna L den Boer, Dimitris Rizopoulos, Gideon J du Marchie Sarvaas, Ad P C M Backx, Arend D J Ten Harkel, Gabriëlle G van Iperen, Lukas A J Rammeloo, Ronald B Tanke, Eric Boersma, Willem A Helbing, Michiel Dalinghaus
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is an important predictor of outcome in adults with heart failure. In children with heart failure secondary to dilated cardiomyopathy (DC) markers that reliably predict disease progression and outcome during follow-up are scarce. We investigated whether serial NT-proBNP measurements were predictive for outcome in children with DC. All available NT-proBNP measurements in children with DC were analyzed. Linear mixed-effect models and Cox regression were used to analyze the predictive value of NT-proBNP on the end point of cardiac death (death, heart transplantation, or mechanical circulatory support)...
August 30, 2016: American Journal of Cardiology
Omar Wever-Pinzon, Leah B Edwards, David O Taylor, Abdallah G Kfoury, Stavros G Drakos, Craig H Selzman, James C Fang, Lars H Lund, Josef Stehlik
BACKGROUND: Survival beyond 1 year after heart transplantation has remained without significant improvement for the last 2 decades. A more individualized approach to post-transplant care could result in a reduction of long-term mortality. Although recipient age has been associated with an increased incidence of certain post-transplant morbidities, its effect on cause-specific mortality has not been established. METHODS: We analyzed overall and cause-specific mortality of heart transplant recipients registered in the International Society for Heart and Lung Transplantation Registry between 1995 and 2011...
August 20, 2016: Journal of Heart and Lung Transplantation
Van-Khue Ton, Gordana Vunjak-Novakovic, Veli K Topkara
Left ventricular assist device (LVAD) therapy has revolutionized the treatment of patients with advanced heart failure. Although originally intended for bridge-to-transplantation and destination therapy indications, a small subset of patients supported with LVADs exhibit complete myocardial recovery leading to device explanation. However, genetic and molecular determinants of partial and/or complete myocardial recovery remain largely unknown. Areas covered: We summarize current knowledge on alterations in heart failure transcriptome in response to LVAD support, as well as discuss common gene signatures potentially responsible for the reverse remodeling phenotype in the failing human heart...
October 14, 2016: Expert Review of Medical Devices
Amritha Yellamilli, Jop H van Berlo
The heart has a limited ability to regenerate. It is important to identify therapeutic strategies that enhance cardiac regeneration in order to replace cardiomyocytes lost during the progression of heart failure. Cardiac progenitor cells are interesting targets for new regenerative therapies because they are self-renewing, multipotent cells located in the heart. Cardiac side population cells (cSPCs), the first cardiac progenitor cells identified in the adult heart, have the ability to differentiate into cardiomyocytes, endothelial cells, smooth muscle cells, and fibroblasts...
2016: Frontiers in Cell and Developmental Biology
Braghadheeswar Thyagarajan, Monisha Priyadarshini Kumar, Rutuja R Sikachi, Abhinav Agrawal
Heart failure is one of the leading causes of death in developed nations. End stage heart failure often requires cardiac transplantation for survival. The left ventricular assist device (LVAD) has been one of the biggest evolvements in heart failure management often serving as bridge to transplant or destination therapy in advanced heart failure. Like any other medical device, LVAD is associated with complications with infections being reported in many patients. Endocarditis developing secondary to the placement of LVAD is not a frequent, serious and difficult to treat condition with high morbidity and mortality...
August 2016: Intractable & Rare Diseases Research
Walter P Jeske, Jeanine M Walenga, Bryan Menapace, Jeffrey Schwartz, Mamdouh Bakhos
For heart failure patients unable to undergo cardiac transplantation, mechanical circulatory support with left ventricular assist devices can be utilized. These devices improve quality of life and prolong life expectancy, but they are associated with bleeding and thrombotic complications impacting patient survival. Little is known of the relevant mechanisms of these hemostatic issues, hindering identification of a clinically useful biomarker. However, there is suggestive evidence that blood cell-derived microparticles may fulfill this unmet clinical need...
October 2016: Biomarkers in Medicine
Garry R Thomas, Michael A McDonald, Jennifer Day, Heather J Ross, Diego H Delgado, Filio Billia, Jagdish W Butany, Vivek Rao, Eitan Amir, Philippe L Bedard, Paaladinesh Thavendiranathan
Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and nonischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiographic parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study...
August 23, 2016: American Journal of Cardiology
Damiano Magrì, Federica Re, Giuseppe Limongelli, Piergiuseppe Agostoni, Elisabetta Zachara, Michele Correale, Vittoria Mastromarino, Caterina Santolamazza, Matteo Casenghi, Giuseppe Pacileo, Fabio Valente, Marco Morosin, Beatrice Musumeci, Erika Pagannone, Antonello Maruotti, Massimo Uguccioni, Massimo Volpe, Camillo Autore
BACKGROUND: Heart failure (HF) progression and its complications represent major emergent concerns in hypertrophic cardiomyopathy (HCM). We investigated the possible adjunctive role of cardiopulmonary exercise testing (CPET) in predicting HF-related events. An exercise-derived risk model, theHYPertrophicExercise-derivedRiskHF(HYPERHF), has been developed. METHODS AND RESULTS: A multicenter cohort of 620 consecutive HCM outpatients was recruited and followed (2007 to 2015)...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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