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https://www.readbyqxmd.com/read/28647918/designing-future-clinical-trials-in-heart-failure-with-preserved-ejection-fraction-lessons-from-topcat
#1
REVIEW
Ravi B Patel, Sanjiv J Shah, Gregg C Fonarow, Javed Butler, Muthiah Vaduganathan
PURPOSE OF REVIEW: Spironolactone did not demonstrate benefit with respect to the primary composite endpoint in the global TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial in patients with chronic heart failure with preserved ejection fraction (HFpEF). We identify key lessons from the TOPCAT experience that can be applied to future HFpEF trials. RECENT FINDINGS: Subsequent analyses of TOPCAT have revealed marked regional heterogeneity in patient profiles, event rates, drug adherence, and treatment effects...
June 24, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28647630/endovascular-repair-of-iatrogenic-iliocaval-fistula-causing-high-output-cardiac-failure-after-spine-fusion
#2
Seth Noland, Carlos A Espinoza, Jonathan D Dvorak, John D Rose, C Steven Powell
The case being presented is a 35-year-old female with a three-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventricle (LV) systolic function, enlarged right ventricle (RV), functional tricuspid regurgitation (TR) and moderate pulmonary hypertension. A computed tomography (CT) scan of the abdomen and pelvis demonstrated findings consistent with an arteriovenous fistula (AVF) between the right common iliac artery and the inferior vena cava (IVC)...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647057/prevalence-of-obstructive-sleep-apnoea-in-acute-coronary-syndrome-routine-screening-in-intensive-coronary-care-units
#3
S Morra, F Bughin, K Solecki, M Aboubadra, B Lattuca, F Gouzi, J-C Macia, T-T Cung, S Cade, F Cransac, J-M Davy, Y Dauvilliers, D Corrado, F Roubille
INTRODUCTION: Increased evidence has shown that, despite the maximum care afforded to patients admitted with acute coronary syndromes (ACS), a residual risk of mortality remains, in which obstructive sleep apnoea (OSA) appears to be a largely undiagnosed factor, particularly in the intensive cardiac care unit (ICCU). The purpose of this study is to determine whether the systematic screening for sleep-disordered breathing (SDB) is feasible and may be recommended. The aims of our study are to determine: (1) The estimated prevalence of OSA in patients admitted to the ICCU for ACS determined by a validated, user-friendly portable screening device; (2) The feasibility of the screening in this context; (3) To assess any negative impact of OSA on the severity of ACS...
June 21, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28646592/influence-of-inspiratory-resistive-loading-on-expiratory-muscle-fatigue-in-healthy-humans
#4
Carli M Peters, Joseph F Welch, Paolo B Dominelli, Yannick Molgat-Seon, Lee M Romer, Donald C McKenzie, A William Sheel
Expiratory resistive loading elicits inspiratory as well as expiratory muscle fatigue, suggesting parallel co-activation of the inspiratory muscles during expiration. It is unknown whether the expiratory muscles are similarly co-activated to the point of fatigue during inspiratory resistive loading (IRL). The purpose of this study was to determine whether IRL elicits expiratory as well as inspiratory muscle fatigue. Healthy male subjects (n = 9) underwent isocapnic IRL (60% maximal inspiratory pressure, 15 breaths∙min(-1) , 0...
June 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28646567/severe-menses-associated-hypertension-successfully-treated-with-gonadotropin-releasing-hormone-agonist
#5
Luke J Laffin, Munnam S Jafar, George L Bakris
A case of a 32-year-old nulliparous white woman referred for a 5-year history of severe hypertension, hypokalemia, and resultant systolic dysfunction is presented. She additionally had a left ventricular ejection fraction of 30% including left ventricular dilation and normal left ventricular mass index, as measured by cardiac magnetic resonance imaging when she initially presented to us. Her history revealed that her severe hypertension episodes were monthly and would occur around the catamenial (menses-associated) time...
June 23, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28646467/symptom-management-challenges-in-heart-failure-pharmacotherapy-considerations
#6
REVIEW
Diana Stewart, Mary Lynn McPherson
Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28646030/metabolic-remodelling-in-hypertrophied-and-failing-myocardium-a-review
#7
Mark Andrew Peterzan, Craig A Lygate, Stefan Neubauer, Oliver Rider
The energy starvation hypothesis proposes that maladaptive metabolic remodelling antedates, initiates and maintains adverse contractile dysfunction in heart failure (HF). Better understanding of the cardiac metabolic phenotype and metabolic signalling could help identify the role metabolic remodelling plays within HF and conditions known to transition toward HF, including 'pathological' hypertrophy. In this review, we discuss metabolic phenotype and metabolic signalling in the contexts of pathological hypertrophy and HF...
June 23, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28646024/metabolic-reprogramming-via-ppar%C3%AE-signaling-in-cardiac-hypertrophy-and-failure-from-metabolomics-to-epigenetics
#8
Junco Shibayama Warren, Shin-Ichi Oka, Daniela Zablocki, Junichi Sadoshima
Studies using -omics-based approaches have advanced our knowledge of metabolic remodeling in cardiac hypertrophy and failure. Metabolomic analysis of the failing heart has revealed global changes in mitochondrial substrate metabolism. Peroxisome proliferator-activated receptor alpha (PPARα) plays a critical role in synergistic regulation of cardiac metabolism through transcriptional control. Metabolic reprogramming via PPARα signaling in heart failure ultimately propagates into myocardial energetics. However, emerging evidence suggests that the expression level of PPARα per se does not always explain the energetic state in the heart...
June 23, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28646015/determination-of-the-heart-to-mediastinum-ratio-of-123-i-mibg-uptake-using-dual-isotope-123-i-mibg-99m-tc-tetrofosmin-multi-pinhole-czt-spect-in-patients-with-heart-failure
#9
Tanguy Blaire, Alban Bailliez, Fayçal Ben Bouallègue, Dimitri Bellevre, Denis Agostini, Alain Manrique
The aim of this retrospective study was to determine the heart-to-mediastinum ratio (HMR) of (123)I-metaiodobenzylguanidine (MIBG) uptake obtained using a multi-pinhole cadmium-zinc-telluride (CZT)-based camera (Discovery NM 530c, DNM-530c, GE Healthcare, Milwaukee, WI, USA) in comparison with that obtained using conventional planar imaging (Infinia, GE Healthcare, Milwaukee, WI, USA). Methods: Forty consecutive heart failure patients underwent planar acquisition 4 h after (123)I-MIBG injection (191±41 MBq)...
June 23, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28645959/formal-consensus-to-identify-clinically-important-changes-in-management-resulting-from-the-use-of-cardiovascular-magnetic-resonance-cmr-in-patients-who-activate-the-primary-percutaneous-coronary-intervention-ppci-pathway
#10
Maria Pufulete, Rachel C Brierley, Chiara Bucciarelli-Ducci, John P Greenwood, Stephen Dorman, Richard A Anderson, Jessica Harris, Elisa McAlindon, Chris A Rogers, Barnaby C Reeves
OBJECTIVE: To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. DESIGN: Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus)...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645834/left-ventricular-assist-device-therapy-for-destination-therapy-is-less-invasive-surgery-a-safe-alternative
#11
Sebastian V Rojas, Jasmin S Hanke, Murat Avsar, Philipp R Ahrens, Ove Deutschmann, Kirstin A Tümler, Aitor Uribarri, Sara Rojas-Hernández, Pedro L Sánchez, José M González-Santos, Axel Haverich, Jan D Schmitto
INTRODUCTION AND OBJECTIVES: The number of older patients with congestive heart failure has dramatically increased. Because of stagnating cardiac transplantation, there is a need for an alternative therapy, which would solve the problem of insufficient donor organ supply. Left ventricular assist devices (LVADs) have recently become more commonly used as destination therapy (DT). Assuming that older patients show a higher risk-profile for LVAD surgery, it is expected that the increasing use of less invasive surgery (LIS) LVAD implantation will improve postoperative outcomes...
June 20, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28645802/comparative-effects-of-long-and-short-acting-loop-diuretics-on-mortality-in-patients-with-chronic-heart-failure
#12
Shu Kasama, Takuji Toyama, Masahiko Kurabayashi
BACKGROUND: We previously reported that the long-acting loop diuretic azosemide improves cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF), compared with short-acting furosemide. However, its influence on mortality has not been determined. METHODS: The present study was a further analysis of our previously published study in which azosemide showed improved (123)I-metaiodobenzylguanidine scintigraphic findings compared with furosemide in CHF patients with reduced left ventricular ejection fraction (LVEF)...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28645757/sympathetic-response-and-outcomes-following-renal-denervation-in-patients-with-chronic-heart-failure-12-month-outcomes-from-the-symplicity-hf-feasibility-study
#13
Ingrid Hopper, Edoardo Gronda, Uta C Hoppe, Bengt Rundqvist, Thomas H Marwick, Sharad Shetty, Christopher Hayward, Thomas Lambert, Dagmara Hering, Murray Esler, Markus Schlaich, Antony Walton, Flavio Airoldi, Mathias-Christoph Brandt, Sidney A Cohen, Pascalle Reiters, Henry Krum
BACKGROUND: Heart failure (HF) is associated with chronic sympathetic activation. Renal denervation (RDN) aims to reduce sympathetic activity by ablating the renal sympathetic nerves. We investigated the effect of RDN in patients with chronic HF and concurrent renal dysfunction, in a prospective, multicenter, single-arm feasibility study. METHODS AND RESULTS: Thirty-nine patients with chronic systolic HF (left ventricular ejection fraction [LVEF] <40%, New York Heart Association class II-III,) and renal impairment (estimated glomerular filtration rate [eGFR; assessed with Modification of Diet in Renal Disease equation] <75 mL/min/1...
June 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28645743/role-of-trpc3-and-trpc6-channels-in-the-myocardial-response-to-stretch-linking-physiology-and-pathophysiology
#14
REVIEW
Yohei Yamaguchi, Gentaro Iribe, Motohiro Nishida, Keiji Naruse
Transient receptor potential (TRP) channels constitute a large family of versatile multi-signal transducers. In particular, TRP canonical (TRPC) channels are known as receptor-operated, non-selective cation channels. TRPC3 and TRPC6, two members in the TRPC family, are highly expressed in the heart, and participate in the pathogenesis of cardiac hypertrophy and heart failure as a pathological response to chronic mechanical stress. In the pathological response, myocardial stretch increases intracellular Ca(2+) levels and activates nuclear factor of activated T cells to induce cardiac hypertrophy...
June 20, 2017: Progress in Biophysics and Molecular Biology
https://www.readbyqxmd.com/read/28645107/effects-of-liraglutide-on-hemodynamic-parameters-in-patients-with-heart-failure
#15
Jin Ying Zhang, Xin Yun Wang, Xiang Wang
Glucagon-like peptide-1 analogues improve left ventricular function in patients with acute myocardial infarction. This study aimed to evaluate the effects of liraglutide on hemodynamic parameters in patients with heart failure. A total of 78 patients with heart failure were enrolled in this study between August 2014 and November 2015. Of these, 52 patients were randomized 1:1 to receive either liraglutide or placebo for 7 days. Hemodynamic measurements were made using transpulmonary thermodilution and arterial pulse contour analysis...
June 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28644395/optical-tracking-and-digital-quantification-of-beating-behavior-in-bioengineered-human-cardiac-organoids
#16
Mahesh Devarasetty, Steven Forsythe, Thomas D Shupe, Shay Soker, Colin E Bishop, Anthony Atala, Aleksander Skardal
Organoid and organ-on-a-chip technologies are rapidly advancing towards deployment for drug and toxicology screening applications. Liver and cardiac toxicities account for the majority of drug candidate failures in human trials. Liver toxicity generally produces liver cell death, while cardiac toxicity causes adverse changes in heart beat kinetics. In traditional 2D cultures, beating kinetics can be measured by electrode arrays, but in some 3D constructs, quantifying beating kinetics can be more challenging...
June 23, 2017: Biosensors
https://www.readbyqxmd.com/read/28643891/direct-comparison-of-high-temporal-resolution-cine-mri-with-doppler-ultrasound-for-assessment-of-diastolic-dysfunction-in-mice
#17
Thomas A Roberts, Anthony N Price, Laurence H Jackson, Valerie Taylor, Anna L David, Mark F Lythgoe, Daniel J Stuckey
Diastolic dysfunction is a sensitive early indicator of heart failure and can provide additional data to conventional measures of systolic function. Transmitral Doppler ultrasound, which measures the one-dimensional flow of blood through the mitral valve, is currently the preferred method for the measurement of diastolic function, but the measurement of the left ventricular volume changes using high-temporal-resolution cinematic magnetic resonance imaging (CINE MRI) is an alternative approach which is emerging as a potentially more robust and user-independent technique...
June 23, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/28643218/empagliflozin-improves-left-ventricular-diastolic-dysfunction-in-a-genetic-model-of-type-2-diabetes
#18
Nadjib Hammoudi, Dongtak Jeong, Rajvir Singh, Ahmed Farhat, Michel Komajda, Eric Mayoux, Roger Hajjar, Djamel Lebeche
PURPOSE: Cardiovascular (CV) diseases in type 2 diabetes (T2DM) represent an enormous burden with high mortality and morbidity. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have recently emerged as a new antidiabetic class that improves glucose control, as well as body weight and blood pressure with no increased risk of hypoglycemia. The first CV outcome study terminated with empagliflozin, a specific SGLT2 inhibitor, has shown a reduction in CV mortality and in heart failure hospitalization, suggesting a beneficial impact on cardiac function which remains to be demonstrated...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28642328/leukocyte-diversity-in-resolving-and-nonresolving-mechanisms-of-cardiac-remodeling
#19
REVIEW
Bochra Tourki, Ganesh Halade
In response to myocardial infarction (MI), time-dependent leukocyte infiltration is critical to program the acute inflammatory response. Post-MI leukocyte density, residence time in the infarcted area, and exit from the infarcted injury predict resolving or nonresolving inflammation. Overactive or unresolved inflammation is the primary determinant in heart failure pathology post-MI. Here, our review describes supporting evidence that the acute inflammatory response also guides the generation of healing and regenerative mediators after cardiac damage...
June 22, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28641980/cardiomyocyte-specific-overexpression-of-a-37-amino-acid-domain-of-regulator-of-g-protein-signalling-2-inhibits-cardiac-hypertrophy-and-improves-function-in-response-to-pressure-overload-in-mice
#20
Katherine N Lee, Xiangru Lu, Chau Nguyen, Qingping Feng, Peter Chidiac
Regulator of G protein signalling 2 (RGS2) is known to play a protective role in maladaptive cardiac hypertrophy and heart failure via its ability to inhibit Gq and Gs mediated GPCR signalling. We previously demonstrated that RGS2 can also inhibit protein translation and can thereby attenuate cell growth. This G protein-independent inhibitory effect has been mapped to a 37 amino acid domain (RGS2(eb)) within RGS2 that binds to eukaryotic initiation factor 2B (eIF2B). When expressed in neonatal rat cardiomyocytes, RGS2(eb) attenuates both protein synthesis and hypertrophy induced by Gq- and Gs- activating agents...
June 19, 2017: Journal of Molecular and Cellular Cardiology
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