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https://www.readbyqxmd.com/read/28211604/delays-in-treatment-intensification-with-oral-antidiabetic-drugs-and-risk-of-microvascular-and-macrovascular-events-in-patients-with-poor-glycemic-control-an-individual-patient-simulation-study
#1
Henry J Folse, Jayanti Mukherjee, John J Sheehan, Alexandra J Ward, Ryan L Pelkey, Tuan A Dinh, Lei Qin, Jennifer Kim
AIMS: Despite guideline recommendations, many patients with type 2 diabetes on oral antidiabetic drugs (OADs) whose HbA1c results remain above target do not experience timely treatment intensification. This study uses the Archimedes Model® to estimate the consequences of delays in OAD treatment intensification on glycemic control and long-term outcomes at 5 and 20 years. MATERIALS AND METHODS: Using real world data, we modeled a cohort of hypothetical patients with HbA1c ≥8%, on metformin, with no history of insulin use...
February 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28211603/impact-of-six-versus-12-months-of-dual-antiplatelet-therapy-in-patients-with-drug-eluting-stent-implantation-after-risk-stratification-with-the-residual-syntax-score-results-from-a-secondary-analysis-of-the-i-love-it-2-trial
#2
Miaohan Qiu, Yi Li, Jing Li, Kai Xu, Quanmin Jing, Shaohong Dong, Zhe Jin, Pitian Zhao, Bo Xu, Yaling Han
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. OBJECTIVES: This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). METHODS: A total of 2737 patients in the I-LOVE-IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28211197/recurrences-in-the-blanking-period-and-12-month-success-rate-by-continuous-cardiac-monitoring-after-cryoablation-of-paroxysmal-and-non-paroxysmal-atrial-fibrillation
#3
Paolo Pieragnoli, Alessandro Paoletti Perini, Giuseppe Ricciardi, Luca Checchi, Andrea Giomi, Iacopo Muraca, Letizia Mannucci, Luigi Padeletti
INTRODUCTION: Recurrences within the blanking period (early recurrences) are common after atrial fibrillation (AF) ablation by pulmonary vein isolation (PVI), but their clinical significance is still controversial. We aimed at evaluating the significance of within-blanking recurrences at 12-month follow-up after cryoballoon (CB) PVI, and to assess the real procedural success rate by continuous monitoring of cardiac rhythm. METHODS AND RESULTS: Sixty consecutive AF patients (34 paroxysmal, 56...
February 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#4
REVIEW
Amanda Cai, Howard J Eisen
PURPOSE OF REVIEW: As the heart failure population continues to age, the need for definitive therapies such as ventricular assist devices (VADs) to extend life and alleviate suffering from end-stage disease directly increases. The goal of this article is to examine the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of long-term VAD patients. RECENT FINDINGS: Survival rates in VAD-implanted patients have improved in parallel with modernization of device design and surgical technique, reaching that of cardiac transplantation at 1 year post-procedure...
February 16, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28210569/infant-acute-myocarditis-mimicking-acute-myocardial-infarction
#5
Maher Jedidi, Samia Tilouche, Tasnim Masmoudi, Maha Sahnoun, Youssef Chkirbène, Sarra Mestiri, Lamia Boughamoura, Mohamed Ben Dhiab, Mohamed Kamel Souguir
Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28209767/ideal-cardiovascular-health-cardiovascular-remodeling-and-heart-failure-in-blacks-the-jackson-heart-study
#6
Aferdita Spahillari, Sameera Talegawkar, Adolfo Correa, J Jeffrey Carr, James G Terry, João Lima, Jane E Freedman, Saumya Das, Robb Kociol, Sarah de Ferranti, Donya Mohebali, Stanford Mwasongwe, Katherine L Tucker, Venkatesh L Murthy, Ravi V Shah
BACKGROUND: The lifetime risk of heart failure (HF) is higher in the black population than in other racial groups in the United States. METHODS AND RESULTS: We measured the Life's Simple 7 ideal cardiovascular health metrics in 4195 blacks in the JHS (Jackson Heart Study; 2000-2004). We evaluated the association of Simple 7 metrics with incident HF and left ventricular structure and function by cardiac magnetic resonance (n=1188). Mean age at baseline was 54.4 years (65% women)...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28209402/chemokine-receptor-patterns-and-right-heart-failure-in-mechanical-circulatory-support
#7
Aditi Nayak, Colin Neill, Robert L Kormos, Luigi Lagazzi, Indrani Halder, Charles McTiernan, Jennifer Larsen, Ana Inashvili, Jeffrey Teuteberg, Timothy N Bachman, Karen Hanley-Yanez, Dennis M McNamara, Marc A Simon
BACKGROUND: Right ventricular failure (RVF) complicates 9% to 44% of left ventricular assist device (LVAD) implants post-operatively. Current prediction scores perform only modestly in validation studies, and do not include immune markers. Chemokines are inflammatory signaling molecules with a fundamental role in cardiac physiology and stress adaptation. In this study we investigated chemokine receptor regulation in LVAD recipients who develop RVF. METHODS: Expression of chemokine receptor (CCR) genes 3 to 8 were examined in the peripheral blood of 111 LVAD patients, collected 24 hours before implant...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28209386/dietary-therapy-in-heart-failure-with-preserved-ejection-fraction-and-or-left-ventricular-diastolic-dysfunction-in-patients-with-metabolic-syndrome
#8
REVIEW
Helene von Bibra, Alexander Ströhle, Martin St John Sutton, Nicolai Worm
BACKGROUND: Heart failure is an ongoing epidemic of left ventricular (LV) dilatation and/or dysfunction due to the increasing prevalence of predisposing risk factors such as age, physical inactivity, (abdominal) obesity, and type-2-diabetes. Approximately half of these patients have diastolic heart failure (HFpEF). The prognosis of HFpEF is comparable to that of systolic heart failure, but without any known effective treatment. DIASTOLIC DYSFUNCTION: A biomathematically corrected diagnostic approach is presented that quantifies diastolic dysfunction via the predominant age dependency of LV diastolic function and unmasks (metabolic) risk factors, that are independent of age and, therefore, potential targets for therapy...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28209349/frequency-of-and-significance-of-physical-frailty-in-patients-with-heart-failure
#9
Quin E Denfeld, Kerri Winters-Stone, James O Mudd, Shirin O Hiatt, Christopher V Chien, Christopher S Lee
Physical frailty is an important prognostic indicator in heart failure (HF); however, few studies have examined the relation between physical frailty and invasive hemodynamics among adults with HF. The purpose of this study was to characterize physical frailty in HF in relation to invasive hemodynamics. We enrolled 49 patients with New York Heart Association class II to IV HF when participants were scheduled for a right-sided cardiac heart catheterization procedure. Physical frailty was measured according to the "frailty phenotype": shrinking, weakness, slowness, physical exhaustion, and low physical activity...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28209216/hypertrophic-cardiomyopathy-with-left%C3%A2-ventricular-apical-aneurysm-implications-for-risk-stratification-and-management
#10
Ethan J Rowin, Barry J Maron, Tammy S Haas, Ross F Garberich, Weijia Wang, Mark S Link, Martin S Maron
BACKGROUND: A previously under-recognized subset of hypertrophic cardiomyopathy (HCM) patients with left ventricular (LV) apical aneurysms is being identified with increasing frequency. However, risks associated with this subgroup are unknown. OBJECTIVES: The authors aimed to clarify clinical course and prognosis of a large cohort of HCM patients with LV apical aneurysms over long-term follow-up. METHODS: The authors retrospectively analyzed 1,940 consecutive HCM patients at 2 centers, 93 of which (4...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28208977/comparison-of-levosimendan-milrinone-and-dobutamine-in-treating-low-cardiac-output-syndrome-following-valve-replacement-surgeries-with-cardiopulmonary-bypass
#11
Sunny, Mohd Yunus, Habib Md Reazaul Karim, Manuj Kumar Saikia, Prithwis Bhattacharyya, Samarjit Dey
INTRODUCTION: Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. AIM: To compare Levosimendan, Milrinone and Dobutamine for the treatment of LCOS after CPB in patients who underwent valve replacement surgeries. MATERIALS AND METHODS: Sixty eligible patients meeting LCOS were allocated into three treatment groups: Group A-Levosimendan (loading dose 10μg/kg over 10 minutes, followed by 0...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208969/acute-presentation-of-juvenile-dermatomyositis-with-subclinical-cardiac-involvement-a-rare-case
#12
Rhythm Khera, Shrayash Khare, Shailendra Kumar Singh
Cardiac involvements are common in patients with Dermatomyositis, most of which are not severe enough to present definite or readily observable symptoms. However, Cardiovascular (CVS) manifestations constitute a major cause of death in these patients. The most frequently reported clinically evident of CVS manifestations in-patient of dermatomyositis are Congestive Heart Failure (CHF), conduction aberrations, that may predispose to complete heart block and coronary artery disease. The principal pathophysiological mechanisms that may produce these cardiac manifestations involve coronary artery disease as well as small vessels vasculitis of the myocardium...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207554/isolated-cardiac-troponin-rise-does-not-modify-the-prognosis-in-elderly-patients-with-hip-fracture
#13
Hélène Vallet, Alice Breining, Yannick Le Manach, Judith Cohen-Bittan, Anthony Mézière, Mathieu Raux, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Perioperative myocardial infarction remains a life-threatening complication in noncardiac surgery and even an isolated troponin rise (ITR) is associated with significant mortality. Our aim was to assess the prognostic value of ITR in elderly patients with hip fracture.In this cohort study, all patients admitted between 2009 and 2013 in our dedicated geriatric postoperative unit after hip fracture surgery with a cardiac troponin I determination were included and divided into Control, ITR, and acute coronary syndrome (ACS) groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206674/effects-of-spinal-cord-stimulation-on-cardiac-sympathetic-nerve-activity-in-patients-with-heart-failure
#14
Jan Naar, Deborah Jaye, Cecilia Linde, Petr Neužil, Petr Doškář, Filip Málek, Frieder Braunschweig, Lars H Lund, Lars Mortensen, Bengt Linderoth, Göran Lind, Dianna Bone, Arthur J Scholte, Fred Kueffer, Jodi Koehler, Kambiz Shahgaldi, Otto Lang, Marcus Ståhlberg
BACKGROUND: Spinal cord stimulation (SCS) reduces sympathetic activity in animal models of heart failure with reduced ejection fraction (HF) but limited data exist of SCS in patients with HF. The aim of the present study was to test the primary hypothesis that SCS reduces cardiac sympathetic nerve activity in HF patients. Secondary hypotheses were that SCS improves left ventricular function and dimension, exercise capacity and clinical variables relevant to HF. METHODS: HF patients with a SCS device previously participating in the DEFEAT-HF trial were included in this crossover study with 6-week intervention periods (SCS-ON and SCS-OFF)...
February 16, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28205629/mechanisms-of-chinese-medicine-xinmailong-s-protection-against-heart-failure-in-pressure-overloaded-mice-and-cultured-cardiomyocytes
#15
Jianyong Qi, Juan Yu, Yafang Tan, Renshan Chen, Wen Xu, Yanfen Chen, Jun Lu, Qin Liu, Jiashin Wu, Weiwang Gu, Minzhou Zhang
Patients with heart failure (HF) have high mortality and mobility. Xinmailong (XML) injection, a Chinese Medicine, is clinically effective in treating HF. However, the mechanism of XML's effectiveness on HF was unclear, and thus, was the target of the present study. We created a mouse model of pressure-overload-induced HF with transverse aortic constriction (TAC) surgery and compared among 4 study groups: SHAM (n = 10), TAC (n = 12), MET (metoprolol, positive drug treatment, n = 7) and XML (XML treatment, n = 14)...
February 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28205593/imaging-cardiac-scn5a-using-the-novel-f-18-radiotracer-radiocaine
#16
Jacob M Hooker, Martin G Strebl, Frederick A Schroeder, Hsiao-Ying Wey, Amrut V Ambardekar, Timothy A McKinsey, Matthias Schoenberger
The key function of the heart, a well-orchestrated series of contractions, is controlled by cardiac action potentials. These action potentials are initiated and propagated by a single isoform of voltage gated sodium channels - SCN5A. However, linking changes in SCN5A expression levels to human disease in vivo has not yet been possible. Radiocaine, an F-18 radiotracer for positron emission tomography (PET), is the first SCN5A imaging agent in the heart. Explants from healthy and failing human hearts were compared using radiocaine autoradiography to determine that the failing heart has ~30% lower SCN5A levels - the first evidence of changes in SCN5A expression in humans as a function of disease...
February 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28205339/doing-it-hard-in-the-bush-aligning-what-gets-measured-with-what-matters
#17
Malcolm I McDonald, Kenny D Lawson
What gets measured gets managed. Funding of health services is substantially determined by operational activity and specific outcome indicators. In day-to-day clinical decision-making, surrogate markers, such as glycosylated haemoglobin and blood pressure, are commonly used to modify risks of 'hard' outcomes that include kidney failure, ischaemic cardiac events, stroke and all-cause mortality. In many settings, surrogates are all we have to go on. As a consequence, current health funding models heavily rely on surrogate-based key performance indicators [KPIs]...
February 16, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28203406/effects-of-recombinant-human-brain-natriuretic-peptide-on-the-prognosis-of-patients-with-acute-anterior-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-a-prospective-multi-center-randomized-clinical-trial
#18
Zhi-Lin Miao, Ai-Jie Hou, Hong-Yun Zang, Ru-Gang Huang, Xiao-Qun Zheng, Hai-Long Lin, Wei Wang, Ping Hou, Fei Xia, Zhan-Quan Li
BACKGROUND: This study aims to investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on serum enzyme data, cardiac function parameters and cardiovascular events in patients with acute anterior myocardial infarction (MI). METHODS: A total of 421 patients with acute anterior or extensive anterior MI were collected from 20 hospitals. These patients were randomly divided into two groups: rhBNP and control groups. Both groups of patients received primary percutaneous coronary intervention (PCI) within the effective time window...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28202772/high-throughput-screening-of-tyrosine-kinase-inhibitor-cardiotoxicity-with-human-induced-pluripotent-stem-cells
#19
Arun Sharma, Paul W Burridge, Wesley L McKeithan, Ricardo Serrano, Praveen Shukla, Nazish Sayed, Jared M Churko, Tomoya Kitani, Haodi Wu, Alexandra Holmström, Elena Matsa, Yuan Zhang, Anusha Kumar, Alice C Fan, Juan C Del Álamo, Sean M Wu, Javid J Moslehi, Mark Mercola, Joseph C Wu
Tyrosine kinase inhibitors (TKIs), despite their efficacy as anticancer therapeutics, are associated with cardiovascular side effects ranging from induced arrhythmias to heart failure. We used human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), generated from 11 healthy individuals and 2 patients receiving cancer treatment, to screen U.S. Food and Drug Administration-approved TKIs for cardiotoxicities by measuring alterations in cardiomyocyte viability, contractility, electrophysiology, calcium handling, and signaling...
February 15, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28202161/complication-profile-failure-to-rescue-and-mortality-following-elective-endovascular-aortic-aneurysm-repair
#20
David S Kauvar, Eric D Martin, Todd E Simon, Matthew D Givens
INTRODUCTION: Understanding the relationship between patient risk factors, postoperative complications, and morbidity and mortality is important when considering elective endovascular aortic aneurysm repair (E-EVAR) performed to prevent aneurysm rupture mortality. We aimed to stratify complications in E-EVAR and explore their relationship with postoperative death. METHODS: E-EVAR cases from 2012 NSQIP were identified. 30-day complications were categorized as major (MAJCX) or minor (MINCX) using the Clavien-Dindo classification...
February 8, 2017: American Journal of Surgery
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