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https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#1
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329248/clinical-characteristics-of-wild-type-transthyretin-cardiac-amyloidosis-disproving-myths
#2
Esther González-López, Christian Gagliardi, Fernando Dominguez, Cristina Candida Quarta, F Javier de Haro-Del Moral, Agnese Milandri, Clara Salas, Mario Cinelli, Marta Cobo-Marcos, Massimiliano Lorenzini, Enrique Lara-Pezzi, Serena Foffi, Luis Alonso-Pulpon, Claudio Rapezzi, Pablo Garcia-Pavia
Aims: Wild-type transthyretin amyloidosis (ATTRwt) is mostly considered a disease predominantly of elderly male, characterized by concentric LV hypertrophy, preserved LVEF, and low QRS voltages. We sought to describe the characteristics of a large cohort of ATTRwt patients to better define the disease. Methods and results: Clinical findings of consecutive ATTRwt patients diagnosed at 2 centres were reviewed. ATTRwt was diagnosed histologically or non-invasively (LV hypertrophy ≥12 mm, intense cardiac uptake at 99mTc-DPD scintigraphy and AL exclusion)...
March 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325106/impact-of-age-on-left-ventricular-geometry-and-diastolic-function-in-elderly-patients-with-treated-hypertension
#3
Ayumi Toba, Taro Kariya, Rie Aoyama, Taizo Ishiyama, Yusuke Tsuboko, Kazuhiro Takeda, Hajime Fujimoto, Kentaro Shimokado, Kazumasa Harada
PURPOSE: Left ventricular (LV) remodelling is observed in numerous patients with hypertension and is a principal cause of heart failure in elderly patients. The aim of this study was to determine the relationships between age and structural/functional LV remodelling observed in elderly hypertensive patients. METHODS: A total of 557 elderly hypertensive patients (mean age: 74.0 ± 8.6 years) with preserved LV systolic function underwent echocardiography and 24-hour blood pressure (BP) measurement...
March 22, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28320991/pre-procedural-risk-score-of-contrast-induced-nephropathy-in-elderly-patients-undergoing-elective-coronary-angiography
#4
Dan Lian, Yong Liu, Yuan-Hui Liu, Hua-Long Li, Chong-Yang Duan, Dan-Qing Yu
To establish a scoring model to predict the risk of contrast-induced nephropathy (CIN) in elderly patients undergoing elective coronary angiography (CAG).A total of 1286 patients aged > 65 years who had undergone elective CAG between August 2009 and February 2013 were enrolled in this study. They were randomly (3:2) assigned to a development (n = 756) or validation dataset (n = 530). Independent predictors of CIN were identified by using logistic regression and were assigned a weighted integer, which was used to establish a score model...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#5
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28316006/management-of-heart-failure-with-preserved-ejection-fraction-current-challenges-and-future-directions
#6
REVIEW
Bharathi Upadhya, Dalane W Kitzman
Heart failure (HF) with preserved ejection fraction (HFpEF) is the most common form of HF in patients older than 65 years. Among elderly women living in the community, HFpEF comprises nearly 90% of incident HF cases. The health and economic impact of HFpEF is at least as great as that of HF with reduced ejection fraction (HFrEF), with similar severity of acute hospitalization rates and substantial mortality. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined...
March 18, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28301912/potential-causes-and-implications-of-low-target-therapeutic-ratio-in-warfarin-treated-patients-for-thrombosis-prophylaxis
#7
Halil Atas, Ahmet Anıl Sahin, Dilek Barutçu Atas, Murat Sunbul, Alper Kepez, Mehmet Agirbasli
Time in therapeutic range (TTR) of international normalized ratio is crucial for the safety and efficacy of anticoagulation with warfarin and it is influenced by many factors. There are limited data about the quality of warfarin therapy and its effects on clinical outcomes in Turkey. The aim of this study is to demonstrate the quality of anticoagulant therapy with warfarin and evaluate the parameters that affect the quality of warfarin therapy. A total of 170 patients with atrial fibrillation (AF; mean age: 62...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28295985/heart-failure-with-mid-range-ejection-fraction-a-distinct-clinical-entity-insights-from-the-trial-of-intensified-versus-standard-medical-therapy-in-elderly-patients-with-congestive-heart-failure-time-chf
#8
Peter Rickenbacher, Beat A Kaufmann, Micha T Maeder, Alain Bernheim, Kaatje Goetschalckx, Otmar Pfister, Matthias Pfisterer, Hans-Peter Brunner-La Rocca
AIMS: While the conditions of heart failure (HF) with reduced (HFrEF, LVEF < 40%) and preserved (HFpEF, LVEF ≥ 50%) left ventricular ejection fraction (LVEF) are well characterized, it is unknown whether patients with HF and mid-range LVEF (HFmrEF, LVEF 40-49%) have to be regarded as a separate clinical entity. The aim of this study was to characterize these three populations and to compare outcome and response to therapy. METHODS AND RESULTS: The analysis was based on the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) comprising a population with established HF including the whole spectrum of LVEF...
March 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28295604/larger-right-atrium-than-left-atrium-is-associated-with-all-cause-mortality-in-elderly-patients-with-heart-failure
#9
Qays Almodares, Cecilia Wallentin Guron, Anders Thurin, Michael Fu, Silvana Kontogeorgos, Erik Thunstrom, Magnus C Johansson
BACKGROUND: While left atrial (LA) enlargement is known as an early sign of left heart disease with prognostic implications in heart failure (HF), the importance of right atrial (RA) enlargement is less well studied, and the prognostic implications of interatrial size comparison are insufficiently understood. The aim of this study was to test the hypothesis that RA area larger than LA area in apical four-chamber view is associated with all-cause mortality in elderly patients with HF independent of left ventricular ejection fraction (LVEF)...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28294372/alcohol-and-cardiovascular-disease-in-the-geriatric-population
#10
REVIEW
Aditi Kalla, Vincent M Figueredo
There has been little focus on the effects of alcohol on the elderly. Although the cardiovascular benefits of moderate alcohol consumption could be of the greatest benefit in this group, so might be the detrimental effects of abuse. In this article, we review available data on the effects of alcohol consumption on cardiovascular disease, cardiomyopathy, arrhythmias, hypertension, and vascular function in older adults. Alcohol consumption has increased in the US population age 65 years and older in the last decade, as has monthly heavy episodic drinking in older alcohol consumers...
March 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28288193/nonalcoholic-fatty-liver-disease-and-increased-risk-of-1-year-all-cause-and-cardiac-hospital-readmissions-in-elderly-patients-admitted-for-acute-heart-failure
#11
Filippo Valbusa, Stefano Bonapace, Davide Agnoletti, Luca Scala, Cristina Grillo, Pietro Arduini, Emanuela Turcato, Alessandro Mantovani, Giacomo Zoppini, Guido Arcaro, Christopher Byrne, Giovanni Targher
Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for heart failure (HF). Although some progress has been made in improving survival among patients admitted for HF, the rates of hospital readmissions and the related costs continue to rise dramatically. We sought to examine whether NAFLD and its severity (diagnosed at hospital admission) was independently associated with a higher risk of 1-year all-cause and cardiac re-hospitalization in patients admitted for acute HF. We studied 212 elderly patients who were consecutively admitted with acute HF to the Hospital of Negrar (Verona) over a 1-year period...
2017: PloS One
https://www.readbyqxmd.com/read/28287293/-classical-antihypertensive-drugs-diuretics
#12
Viktor László Nagy
The diuretics are essential medicaments of antihypertensive therapy. They reduce blood pressure and cardiovascular events optimally. With increasing doses of thiazides and thiazide analogs do not come further powerful effect of reducing blood pressure or cardiovascular mortality and morbidity, but clearly elevate the side effects. Because of it, the minimum effective dose level and the fixed-dose combination therapy should be preferred. The use these drugs leads to especially positive outcome in elder patients, isolated systolic hypertension, heart failure, after stroke and in black population...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28286991/cardiovascular-disease-in-women-is-it-different-to-men-the-role-of-sex-hormones
#13
REVIEW
G M C Rosano, I Spoletini, C Vitale
Cardiovascular disease in women differs in clinical presentation, pathophysiology and prognosis from that in men. The role of estrogens and androgens may help explain such sex dimorphisms, being involved in cardiac function, endothelial function and vascular tone. In particular, the cardioprotective effect of estrogen replacement therapy is observed in postmenopausal women in a time-dependent manner, i.e. when it is initiated at their first menopausal symptoms. Postmenopausal women, beyond aged men, may also benefit from testosterone supplementation therapy...
April 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28279964/serum-creatinine-elevation-after-renin-angiotensin-system-blockade-and-long-term-cardiorenal-risks-cohort-study
#14
Morten Schmidt, Kathryn E Mansfield, Krishnan Bhaskaran, Dorothea Nitsch, Henrik Toft Sørensen, Liam Smeeth, Laurie A Tomlinson
Objective To examine long term cardiorenal outcomes associated with increased concentrations of creatinine after the start of angiotensin converting enzyme inhibitor/angiotensin receptor blocker treatment.Design Population based cohort study using electronic health records from the Clinical Practice Research Datalink and Hospital Episode Statistics.Setting UK primary care, 1997-2014.Participants Patients starting treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers (n=122 363)...
March 9, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28279368/imaging-guided-cardioprotective-treatment-in-a-community-elderly-population-of-stage-b-heart-failure
#15
Hong Yang, Kazuaki Negishi, Ying Wang, Mark Nolan, Thomas H Marwick
OBJECTIVES: The purpose of the study was to evaluate the benefit of care guided by the detection of stage B heart failure (SBHF) using advanced echocardiography for the reduction of new HF in the community. BACKGROUND: The detection of nonischemic SBHF has been facilitated by advanced echocardiographic imaging modalities. However, improved outcomes have not been proven as they are predicated on benefit of treatment. METHODS: Between September 13, 2013 and November 6, 2015, 618 asymptomatic community-based patients with HF risks (age 71 ± 5 years) were randomized to care guided by advanced echocardiography (myocardial deformation and detailed diastolic function) versus usual care...
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28269227/evaluation-of-periodic-breathing-in-respiratory-flow-signal-of-elderly-patients-using-svm-and-linear-discriminant-analysis
#16
Sara Argerich, Sergio Herrera, Salvador Benito, Beatriz F Giraldo
Aging population is a major concern that is reflected in the increase of chronic diseases. Heart Failure (HF) is one of the most common chronic diseases of elderly people that is punctuated with acute episodes, which result in hospitalization. The periodic modulation of the amplitude of the breathing pattern is proved to be one of the multiple symptoms of an acute episode, and thus, the features extracted from its characterization contribute in the improvement of the first diagnosis of the clinical practice...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28262214/hospital-management-of-acute-decompensated-heart-failure
#17
REVIEW
Ashraf S Abdo
Heart failure (HF) is one of the leading causes of hospitalizations for elderly adults in the United States. One in 5 Americans will be >65 years of age by 2050. Because of the high prevalence of HF in this group, the number of Americans requiring hospitalization for this disorder is expected to rise significantly. We reviewed the most recent and ongoing studies and recommendations for the management of patients hospitalized due to decompensated HF. The Acute Decompensated Heart Failure National Registry, together with the 2013 American College of Cardiology Foundation and American Heart Association heart failure guidelines, earlier retrospective and prospective studies including the Diuretic Optimization Strategies Evaluation (DOSE), the Trial of Intensified vs Standard Medical Therapy in the Elderly Patients With Congestive Heart Failure (TIME-CHF), the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF), the Rapid Emergency Department Heart Failure Outpatient Trial (REDHOT) and the Comparison of Medical, Pacing and Defibrillation Therapies in Heart Failure (COMPANION) trial were reviewed for current practices pertaining to these patients...
March 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28259551/diagnostic-yield-of-device-interrogation-in-the-evaluation-of-syncope-in-an-elderly-population
#18
Robert N D'Angelo, Christopher C Pickett
BACKGROUND: Device interrogation has become a standard part of the syncope evaluation for patients admitted with permanent pacemakers (PPM) or implantable cardiac defibrillators (ICD), although few studies have shown interrogation yields clinically useful data. The purpose of this study is to determine the diagnostic yield of device interrogation as well as other commonly performed tests in the workup of unexplained syncope in patients with previously implanted PPMs or ICDs. METHODS: We retrospectively reviewed records of 88 patients admitted to our medical center for syncope with previously implanted pacemakers between January 1, 2005 and January 1, 2015 using ICD-9 billing data...
February 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28259550/current-use-of-guideline-based-medical-therapy-in-elderly-patients-admitted-with-acute-heart-failure-with-reduced-ejection-fraction-and-its-impact-on-event-free-survival
#19
Keitaro Akita, Takashi Kohno, Shun Kohsaka, Yasuyuki Shiraishi, Yuji Nagatomo, Yuki Izumi, Ayumi Goda, Atsushi Mizuno, Mitsuaki Sawano, Taku Inohara, Keiichi Fukuda, Tsutomu Yoshikawa
BACKGROUND: Acute heart failure (HF) is a frequently encountered cardiac condition. Its prevalence increases exponentially with age. In spite of this, elderly patients are underrepresented in clinical trials and the implementation of guideline-based medical therapy (GBMT) in them is not well established. We investigated the current use of GBMT and its effects on mortality and HF rehospitalization among elderly patients with acute HF with reduced ejection fraction (HFrEF) using data obtained from a contemporary multi-center registry...
February 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28251568/activities-of-daily-living-at-different-levels-of-renal-function-in-elderly-hospitalized-heart-failure-patients
#20
Masahiro Kitamura, Kazuhiro P Izawa, Hiroki Taniue, Yumi Mimura, Yuichi Ikeda, Hitomi Nagashima, Peter H Brubaker
BACKGROUND: Renal function (RF) and activities of daily living (ADL) are risk factors for heart failure (HF) patients. AIMS: We evaluated differences in motor and cognitive ADL in relation to RF in elderly hospitalized HF patients. METHODS: Participants were selected from 414 consecutive hospitalized HF patients based on certain criteria. We investigated patient characteristics including Functional Independence Measure (FIM) and estimated glomerular filtration rate (eGFR)...
March 1, 2017: Aging Clinical and Experimental Research
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