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https://www.readbyqxmd.com/read/28108550/cardiac-resynchronization-therapy-in-adults-with-congenital-heart-disease
#1
Zeliha Koyak, Joris R de Groot, Ahmed Krimly, Tara M Mackay, Berto J Bouma, Candice K Silversides, Erwin N Oechslin, Ulas Hoke, Lieselot van Erven, Werner Budts, Isabelle C Van Gelder, Barbara J M Mulder, Louise Harris
AIMS: In adults with congenital heart disease (CHD) heart failure is one of the leading causes of morbidity and mortality but experience with and reported outcome of cardiac resynchronization therapy (CRT) is limited. We investigated the efficacy of CRT in adults with CHD. METHODS AND RESULTS: This was a retrospective study including 48 adults with CHD who received CRT since 2003 in four tertiary referral centres. Responders were defined as patients who showed improvement in NYHA functional class and/or systemic ventricular ejection fraction by at least one category...
January 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28107664/safety-and-efficacy-of-cardiopoietic-stem-cells-in-the-treatment-of-post-infarction-left-ventricular-dysfunction-from-cardioprotection-to-functional-repair-in-a-translational-pig-infarction-model
#2
Maximilian Y Emmert, Petra Wolint, Andras Jakab, Sean P Sheehy, Francesco S Pasqualini, Thi Dan Linh Nguyen, Monika Hilbe, Burkhardt Seifert, Benedikt Weber, Chad E Brokopp, Dominika Macejovska, Etem Caliskan, Arnold von Eckardstein, Ruth Schwartlander, Viola Vogel, Volkmar Falk, Kevin Kit Parker, Mariann Gyöngyösi, Simon P Hoerstrup
To date, clinical success of cardiac cell-therapies remains limited. To enhance the cardioreparative properties of stem cells, the concept of lineage-specification through cardiopoietic-guidance has been recently suggested. However, so far, only results from murine studies and from a clinical pilot-trial in chronic heart-failure (CHF) are available, while systematic evidence of its therapeutic-efficacy is still lacking. Importantly, also no data from large animals or for other indications are available. Therefore, we here investigate the therapeutic-efficacy of human cardiopoietic stem cells in the treatment of post-infarction LV-dysfunction using a translational pig-model...
November 23, 2016: Biomaterials
https://www.readbyqxmd.com/read/28107271/perioperative-care-of-the-patient-with-the-total-artificial-heart
#3
Jill Yaung, Francisco A Arabia, Michael Nurok
Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28100834/soft-robotic-sleeve-supports-heart-function
#4
Ellen T Roche, Markus A Horvath, Isaac Wamala, Ali Alazmani, Sang-Eun Song, William Whyte, Zurab Machaidze, Christopher J Payne, James C Weaver, Gregory Fishbein, Joseph Kuebler, Nikolay V Vasilyev, David J Mooney, Frank A Pigula, Conor J Walsh
There is much interest in form-fitting, low-modulus, implantable devices or soft robots that can mimic or assist in complex biological functions such as the contraction of heart muscle. We present a soft robotic sleeve that is implanted around the heart and actively compresses and twists to act as a cardiac ventricular assist device. The sleeve does not contact blood, obviating the need for anticoagulation therapy or blood thinners, and reduces complications with current ventricular assist devices, such as clotting and infection...
January 18, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28095452/influence-of-mechanical-circulatory-support-on-endothelin-receptor-expression-in-human-left-ventricular-myocardium-from-patients-with-dilated-cardiomyopathy-dcm
#5
Florian Gärtner, Getu Abraham, Astrid Kassner, Daniela Baurichter, Hendrik Milting
BACKGROUND: In terminal failing hearts ventricular assist devices (VAD) are implanted as a bridge to transplantation. Endothelin receptor (ETR) antagonists are used for treatment of secondary pulmonary hypertension in VAD patients. However, the cardiac ETR regulation in human heart failure and during VAD support is incompletely understood. METHODS: In paired left ventricular samples of 12 dilated cardiomyopathy patients we investigated the density of endothelin A (ETA) and B (ETB) receptors before VAD implantation and after device removal...
2017: PloS One
https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#6
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28092203/machine-learning-of-three-dimensional-right-ventricular-motion-enables-outcome-prediction-in-pulmonary-hypertension-a-cardiac-mr-imaging-study
#7
Timothy J W Dawes, Antonio de Marvao, Wenzhe Shi, Tristan Fletcher, Geoffrey M J Watson, John Wharton, Christopher J Rhodes, Luke S G E Howard, J Simon R Gibbs, Daniel Rueckert, Stuart A Cook, Martin R Wilkins, Declan P O'Regan
Purpose To determine if patient survival and mechanisms of right ventricular failure in pulmonary hypertension could be predicted by using supervised machine learning of three-dimensional patterns of systolic cardiac motion. Materials and Methods The study was approved by a research ethics committee, and participants gave written informed consent. Two hundred fifty-six patients (143 women; mean age ± standard deviation, 63 years ± 17) with newly diagnosed pulmonary hypertension underwent cardiac magnetic resonance (MR) imaging, right-sided heart catheterization, and 6-minute walk testing with a median follow-up of 4...
January 16, 2017: Radiology
https://www.readbyqxmd.com/read/28089194/left-ventricular-global-longitudinal-strain-predicts-major-adverse-cardiac-events-and-all-cause-mortality-in-heart-transplant-patients
#8
Tor Skibsted Clemmensen, Hans Eiskjær, Brian Bridal Løgstrup, Lars Bo Ilkjær, Steen Hvitfeldt Poulsen
BACKGROUND: Left ventricular global longitudinal strain (LVGLS) is a robust longitudinal myocardial deformation marker that is strongly affected by cardiac allograft vasculopathy (CAV), microvascular dysfunction, and acute cellular rejection (ACR). We evaluated graft deformation for risk stratification in long-term heart transplant (HTx) patients. METHODS: The study included 196 patients who underwent HTx between 2011 and 2013. Patients underwent comprehensive echocardiography and coronary angiography...
December 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28070248/childhood-cardiomyopathies-a-study-in-tertiary-care-hospital-in-upper-egypt
#9
Mohamed Abd Elaal Bakeet, Montaser Mohamed Mohamed, Ahmed Ahmed Allam, Rania Gamal
INTRODUCTION: Cardiomyopathy (CMP) is defined by the World Health Organization (WHO) as a disease of the myocardium associated with cardiac dysfunction. An understanding of CMP is very important, as it is a common cause of heart failure in children, and the most common indication for heart transplantation in children older than one year, but data on CMP in Egypt are scarce. The aim of this study was to determine the number, risk factors, clinical presentation, complications and outcome of different types of childhood cardiomyopathies in Sohag University Hospital...
November 2016: Electronic Physician
https://www.readbyqxmd.com/read/28057794/purinergic-signaling-in-the-cardiovascular-system
#10
REVIEW
Geoffrey Burnstock
There is nervous control of the heart by ATP as a cotransmitter in sympathetic, parasympathetic, and sensory-motor nerves, as well as in intracardiac neurons. Centers in the brain control heart activities and vagal cardiovascular reflexes involve purines. Adenine nucleotides and nucleosides act on purinoceptors on cardiomyocytes, AV and SA nodes, cardiac fibroblasts, and coronary blood vessels. Vascular tone is controlled by a dual mechanism. ATP, released from perivascular sympathetic nerves, causes vasoconstriction largely via P2X1 receptors...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28056816/optimization-of-pressure-settings-during-adaptive-servo-ventilation-support-using-real-time-heart-rate-variability-assessment-initial-case-report
#11
Teruhiko Imamura, Daisuke Nitta, Koichiro Kinugawa
BACKGROUND: Adaptive servo-ventilation (ASV) therapy is a recent non-invasive positive pressure ventilation therapy that was developed for patients with heart failure (HF) refractory to optimal medical therapy. However, it is likely that ASV therapy at relatively higher pressure setting worsens some of the patients' prognosis compared with optimal medical therapy. Therefore, identification of optimal pressure settings of ASV therapy is warranted. CASE PRESENTATION: We present the case of a 42-year-old male with HF, which was caused by dilated cardiomyopathy, who was admitted to our institution for evaluating his eligibility for heart transplantation...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28043679/presence-of-implantable-cardioverter-defibrillators-and-wait-list-mortality-of-patients-supported-with-left-ventricular-assist-devices-as-bridge-to-heart-transplantation
#12
Ahmad Younes, Sadeer G Al-Kindi, Wissam Alajaji, Judith A Mackall, Guilherme H Oliveira
BACKGROUND: The role of implantable cardioverter defibrillator (ICD) in reducing mortality in patients with left ventricular assisted devices (LVADs) listed for heart transplant remains unclear. We therefore, sought to interrogate whether ICDs are associated with reduced mortality in patients with LVADs listed for heart transplantation. METHODS: We searched the United Network for Organ Sharing (UNOS) Registry for LVAD patients (age≥18years) with dilated cardiomyopathies listed for heart transplantation (2008-2015)...
December 28, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28043466/increasing-complexity-of-heart-transplantation-in-patients-with-congenital-heart-disease
#13
William Y Shi, Pankaj Saxena, Matthew S Yong, Silvana F Marasco, David C McGiffin, Anne Shipp, Robert G Weintraub, Yves d'Udekem, Christian P Brizard, Igor E Konstantinov
Owing to improved surgical results, there is a growing population of patients with repaired congenital heart disease (CHD) requiring heart transplantation. The objective of the study was to review our experience in these patients. A retrospective review of the outcomes of heart transplantation in patients with CHD (n = 77) between 1988 and 2014 was performed. Outcomes of early (1988-1999) and late (2000-2014) eras were compared. In results, the mean age was 18 ± 14 years (range: 16 days-58 years). Seventy (91%) patients underwent a mean of 2...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041955/cardiac-dysfunction-in-children-and-young-adults-with-heart-transplantation-a-comprehensive-echocardiography-study
#14
Marcello Chinali, Claudia Esposito, Giorgia Grutter, Roberta Iacobelli, Alessandra Toscano, Maria Grazia D'Asaro, Alessia Del Pasqua, Gianluca Brancaccio, Francesco Parisi, Fabrizio Drago, Gabriele Rinelli
BACKGROUND: Transplanted heart dysfunction is a serious life-threatening condition in pediatric transplant recipients. Several studies have focused on echocardiographic detection of early signs of cardiac dysfunction in this population. We evaluated advanced echocardiographic indices of cardiac function in a large sample of children and young adults with heart transplants with apparently normal cardiac function. METHODS: The study included 60 patients with normal ejection fraction with transplantation performed at pediatric age between 1986 and 2014 and 60 healthy control subjects...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28030609/impact-of-exhaled-breath-acetone-in-the-prognosis-of-patients-with-heart-failure-with-reduced-ejection-fraction-hfref-one-year-of-clinical-follow-up
#15
Fabiana G Marcondes-Braga, Guilherme L Batista, Ivano G R Gutz, Paulo H N Saldiva, Sandrigo Mangini, Victor S Issa, Silvia M Ayub-Ferreira, Edimar A Bocchi, Alexandre Costa Pereira, Fernando Bacal
BACKGROUND: The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. OBJECTIVES: To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). METHODS: After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year...
2016: PloS One
https://www.readbyqxmd.com/read/28024941/orthostatic-hypotension-after-continuous-flow-left-ventricular-assist-device-implantation-in-a-patient-with-longstanding-diabetes-mellitus
#16
Derek S Chew, Brett H Shaw, Debra L Isaac, Jonathan G Howlett, Satish R Raj
A continuous-flow left ventricular assist device (CF-LVAD) benefits patients with advanced heart failure as a bridge to cardiac transplantation. However, unanticipated complications may occur. We report a patient with end-stage heart failure and longstanding diabetes who experienced functionally debilitating orthostatic hypotension from autonomic insufficiency after CF-LVAD implantation. This case demonstrates a role for comprehensive autonomic function testing in the workup of orthostatic hypotension after LVAD implantation...
October 28, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28011796/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#17
Ammar M Killu, Jae-Yoon Park, Jaskanwal D Sara, David O Hodge, Bernard J Gersh, Rick A Nishimura, Samuel J Asirvatham, Christopher J McLeod
AIMS: A dilated/end-stage phase of hypertrophic cardiomyopathy (HCM) is rare but well-recognized. The role for cardiac resynchronization therapy (CRT) in this subset of patients remains unexplored. We aimed to clarify the impact of bi-ventricular pacing CRT in dilated/end-stage HCM. METHODS AND RESULTS: The Mayo Clinic HCM database was interrogated to identify patients with ejection fraction (EF) <50% and CRT. Control subjects were identified in 1:1 manner...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28009715/impact-of-lvad-implantation-site-on-ventricular-blood-stagnation
#18
Anthony R Prisco, Alberto Aliseda, Jennifer A Beckman, Nahush A Mokadam, Claudius Mahr, Guilherme J M Garcia
Treatment of end-stage heart failure includes cardiac transplantation or ventricular assist device (VAD) therapy. While increasingly prevalent, current VAD therapy has inherent complications, including thrombosis. Studies have demonstrated that VAD implantation alters intra-cardiac blood flow, creating areas of stagnation that predispose to thrombus formation. Two potential surgical configurations exist for VAD implantation: through the apical or diaphragmatic surfaces of the heart. We hypothesized that diaphragmatic implantation causes more stagnation than apical implantation...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27989870/time-course-of-electrical-remodelling-of-native-conduction-after-cardiac-resynchronization-therapy-and-its-impact-on-clinical-outcome
#19
Marta Cvijić, David Žižek, Bor Antolič, Igor Zupan
BACKGROUND: Cardiac resynchronization therapy (CRT) induces structural and electrical remodelling (ER) in heart failure (HF) patients. Our aim was to assess time course of ER of native conduction and mechanical remodelling after CRT and impact of CRT-induced ER on clinical outcome. METHODS AND RESULTS: We prospectively included 62 patients (aged 66±10 years). Echocardiographic and ECG parameters were measured at baseline, 1, 3, 6, 9, and 12 months after implantation...
October 28, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27988989/single-center-outcomes-of-combined-heart-and-liver-transplantation-in-the-failing-fontan
#20
B A D'Souza, S Fuller, L P Gleason, N Hornsby, J Wald, K Krok, A Shaked, L R Goldberg, A Pochettino, K M Olthoff, Y Y Kim
Long-term outcomes of the Fontan operation include Fontan failure and liver disease. Combined heart-liver transplantation (CHLT) is an option for select patients although limited data exist on this strategy. A retrospective review of Fontan patients 18 years or older referred for cardiac transplant evaluation between 2000 and 2013 at the Hospital of the University of Pennsylvania was performed. All patients were considered for potential CHLT. Clinical variables such as demographics, perioperative factors, and short-term outcomes were reviewed...
December 17, 2016: Clinical Transplantation
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