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https://www.readbyqxmd.com/read/28531333/the-flaws-in-the-detail-of-an-observational-study-on-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risks-patients
#1
Fabio Barili, Nick Freemantle, Thierry Folliguet, Claudio Muneretto, Michele De Bonis, Martin Czerny, Jean Francois Obadia, Nawwar Al-Attar, Nikolaos Bonaros, Jolanda Kluin, Roberto Lorusso, Prakash Punjabi, Rafael Sadaba, Piotr Suwalski, Umberto Benedetto, Andreas Böning, Volkmar Falk, Miguel Sousa-Uva, Pieter A Kappetein, Lorenzo Menicanti
The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28531295/right-ventricular-vascular-coupling-in-heart-failure-with-preserved-ejection-fraction-and-pre-vs-post-capillary-pulmonary-hypertension
#2
Thomas M Gorter, Dirk J van Veldhuisen, Adriaan A Voors, Yoran M Hummel, Carolyn S P Lam, Rolf M F Berger, Joost P van Melle, Elke S Hoendermis
Aims: Many patients with heart failure with preserved ejection fraction (HFpEF) develop post-capillary pulmonary hypertension (PH) due to increased left-sided filling pressures. However, a subset of patients develops combined post- and pre-capillary PH. We studied the value of echocardiographic right-sided characterization for the discrimination between pre- vs. post-capillary PH in HFpEF, using invasive haemodynamics as gold standard. Methods and results: 102 consecutive HFpEF patients with simultaneous right heart catheterization and echocardiography were identified...
May 22, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28531281/standard-vs-intensified-management-of-heart-failure-to-reduce-healthcare-costs-results-of-a-multicentre-randomized-controlled-trial
#3
P A Scuffham, J Ball, J D Horowitz, C Wong, P J Newton, P Macdonald, J McVeigh, A Rischbieth, N Emanuele, M J Carrington, C M Reid, Y K Chan, S Stewart
Aims: To determine if an intensified form of heart failure management programme (INT-HF-MP) based on individual profiling is superior to standard management (SM) in reducing health care costs during 12-month follow-up (primary endpoint). Methods and results: A multicentre randomized trial involving 787 patients (full analysis set) discharged from four tertiary hospitals with chronic HF who were randomized to SM (n = 391) or INT-HF-MP (n = 396). Mean age was 74 ± 12 years, 65% had HF with a reduced ejection fraction (31...
May 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28531278/cardiovascular-toxic-effects-of-targeted-cancer-therapy
#4
Kazuko Tajiri, Kazutaka Aonuma, Ikuo Sekine
Over the past decade, there has been a major shift in chemotherapy from non-specific cytotoxic drugs to molecular targeted drug therapies. As more molecular targeted therapies are developed, new types of cardiovascular toxicities induced by targeted therapies are a growing problem. Cardiotoxicity induced by the human epidermal growth factor receptor-2 inhibitor trastuzumab manifests as decreased left ventricular ejection fraction. In contrast to anthracycline treatment, most cardiac events occur during trastuzumab treatment, but are reversed quickly when treatment is interrupted and cardiac intervention is established...
May 20, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#5
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28530489/optimizing-calf-muscle-pump-function
#6
Christopher R Lattimer, Claude Franceschi, Evi Kalodiki
Background The tip toe manoeuvre has been promoted as the gold standard plethysmography test for measuring calf muscle pump function. The aim was to compare the tip toe manoeuvre, dorsiflexion manoeuvre and a body weight transfer manoeuvre using the ejection fraction of air-plethysmography and evaluate which has the best pumping effect. Methods Sixty-six archived tracings on 22 legs were retrieved from an air-plethysmography workshop and analysed. Pumping performance was measured using the calf volume reduction after each manoeuvre...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28530480/ultrasonographic-and-histological-evaluation-of-the-effects-of-long-term-carotid-catheterization-on-cardiac-function-in-nmri-mice
#7
Anne C Teilmann, Morten B Thomsen, Elizabeth A Ihms, Nathan Pate, Jann Hau, Klas Abelson
Catheterization of laboratory mice is commonly performed in biomedical research to infuse substances and for blood sampling. One approach is to catheterize the right common carotid artery and advance the catheter until the tip is positioned in the aorta or the proximal brachiocephalic trunk. Owing to the small body size of the mouse, a catheter tends to occupy a great part of even the larger vessel lumens, and this may increase vascular resistance with potential pathophysiological impacts on the heart. The present study compared cardiac function of catheterized mice, with catheter tip placement in the brachiocephalic trunk, with sham-operated mice and non-operated control mice...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28530211/-pulse-wave-velocity-as-an-early-marker-of-diastolic-heart-failure-in-patients-with-hypertension
#8
Beata Moczulska, Monika Kubiak, Anna Bryczkowska, Ewa Malinowska
According to the WHO, hypertension is one of the major causes of death worldwide. It leads to a number of severe complications. Diastolic heart failure, that is heart failure with preserved ejection fraction (HFPEF), is especially common. New, but simple, indices for the early detection of patients who have not yet developed complications or are in their early developmental stages are still searched for. AIM: The aim of this study is to examine the correlation between pulse wave velocity (PWV) and markers of diastolic heart failure (DHF) assessed in echocardiography in patients with hypertension and no symptoms of heart failure...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#9
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Jeremy Kong, Natalya Neverova, Richard Shlofmitz
OBJECTIVES: This study analyzed the outcomes of patients who presented with non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent orbital atherectomy for severe coronary artery calcification (CAC). BACKGROUND: Patients who present with NSTEMI have increased risk for death and recurrent MI after percutaneous coronary intervention (PCI). Patients with severe CAC have worse outcomes after PCI.Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
May 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28528994/clinical-significance-of-the-overshoot-phenomena-of-respiratory-gas-indices-during-recovery-from-maximal-exercise-testing
#10
Yuta Takayanagi, Akira Koike, Osamu Nagayama, Arisa Nagamine, Rujie Qin, Jo Kato, Isao Nishi, Tomoko Himi, Yuko Kato, Akira Sato, Takeshi Yamashita, Kazutaka Aonuma
BACKGROUND: Overshoot phenomena of the gas exchange ratio (R:VCO2/VO2), ventilatory equivalent for O2 (VE/VO2), and end-tidal O2 pressure (PETO2) are commonly observed during recovery from maximal cardiopulmonary exercise testing (CPX). We investigated the clinical significance of the overshoots of these indices by comparing their magnitudes between healthy subjects and cardiac patients with left ventricular dysfunction. METHODS: In total, 121 subjects (73 healthy subjects and 48 cardiac patients with left ventricular ejection fraction<40%) who underwent CPX and achieved peak R≥1...
May 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28528982/influence-of-renal-dysfunction-phenotype-on-mortality-in-decompensated-heart-failure-with-preserved-and-mid-range-ejection-fraction
#11
Jesús Casado, Marta Sánchez, Vanesa Garcés, Luis Manzano, José Manuel Cerqueiro, Francisco Epelde, David García-Escrivá, José Pérez-Silvestre, José Luis Morales, Manuel Montero-Pérez-Barquero
BACKGROUND: Natriuretic peptides or the blood urea nitrogen to creatinine ratio (BUN/creat) can identify high- vs low-risk renal impairment (RI) in patients with heart failure and reduced ejection fraction (HF-REF). However, the situation in HF patients with preserved ejection fraction (HF-PEF) and mid-range ejection fraction (HF-MREF) remains unclear. METHODS: We evaluated patients from the Spanish National Registry of Heart Failure (RICA) that were admitted to Internal Medicine units with acute decompensated HF...
May 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28528661/right-sided-cardiac-dysfunction-in-heart-failure-with-preserved-ejection-fraction-and-worsening-renal-function
#12
Monica Mukherjee, Kavita Sharma, Jose A Madrazo, Ryan J Tedford, Stuart D Russell, Allison G Hays
In urban populations, worsening renal function (WRF) is well established in patients hospitalized with acute decompensated heart failure with preserved ejection fraction (HFpEF). However, the mechanisms for development of WRF in the setting of acute HF in HFpEF are unclear. In the present study, we sought to characterize conventional echocardiographic measures of right ventricular (RV) chamber size and function to determine whether RV dysfunction and/or adverse RV remodeling is related to WRF in patients with HFpEF...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28528465/contrast-induced-nephropathy-cin-of-patients-with-renal-dysfunction-in-ct-examination
#13
Yasuhiro Fukushima, Hitomi Miyazawa, Junpei Nakamura, Ayako Taketomi-Takahashi, Takayuki Suto, Yoshito Tsushima
PURPOSE: To investigate the incidence and risk factors of contrast induced nephropathy (CIN) after contrast enhanced (CE) computed tomography (CT) in patients with renal dysfunction. MATERIALS AND METHODS: Two hundred sixteen inpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) underwent CE CT using iodine doses of 420 or 480 mg I/kg. Data of all enrolled patients was collected for baseline serum creatinine level (SCr), post-CE CT SCr within 3 days after CE CT, and conditions considered risk factors for CIN [renal dysfunction, contrast media dose, advanced age, diabetes mellitus, no intravenous hydration, cardiac dysfunction (left ventricular ejection fraction <60%) and intensive-care unit (ICU) admission]...
May 20, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28528324/new-role-for-interleukin-13-receptor-%C3%AE-1-in-myocardial-homeostasis-and-heart-failure
#14
Uri Amit, David Kain, Allon Wagner, Avinash Sahu, Yael Nevo-Caspi, Nir Gonen, Natali Molotski, Tal Konfino, Natalie Landa, Nili Naftali-Shani, Galia Blum, Emmanuelle Merquiol, Danielle Karo-Atar, Yariv Kanfi, Gidi Paret, Ariel Munitz, Haim Y Cohen, Eytan Ruppin, Sridhar Hannenhalli, Jonathan Leor
BACKGROUND: The immune system plays a pivotal role in myocardial homeostasis and response to injury. Interleukins-4 and -13 are anti-inflammatory type-2 cytokines, signaling via the common interleukin-13 receptor α1 chain and the type-2 interleukin-4 receptor. The role of interleukin-13 receptor α1 in the heart is unknown. METHODS AND RESULTS: We analyzed myocardial samples from human donors (n=136) and patients with end-stage heart failure (n=177). We found that the interleukin-13 receptor α1 is present in the myocardium and, together with the complementary type-2 interleukin-4 receptor chain Il4ra, is significantly downregulated in the hearts of patients with heart failure...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28528164/mri-derived-myocardial-strain-measures-in-normal-subjects
#15
Ha Q Vo, Thomas H Marwick, Kazuaki Negishi
OBJECTIVES: The aim of this study was to perform a systematic review and meta-analysis to estimate the normal ranges of magnetic resonance imaging (MRI)-based feature tracking (FT) and to identify sources of variations. Similar analyses were also performed for strain encoding, displacement encoding with stimulated echoes, and myocardial tagging. BACKGROUND: MRI-FT is a novel technique for quantification of myocardial deformation using MRI cine images. However, the reported 95% confidence intervals (CIs) from the 2 largest studies have no overlaps...
May 11, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528156/prognostic-impact-of-low-flow-severe-aortic-stenosis-in-small-body-patients-undergoing-tavr-the-ocean-tavi-registry
#16
Akihisa Kataoka, Yusuke Watanabe, Ken Kozuma, Yugo Nara, Fukuko Nagura, Hideyuki Kawashima, Hirofumi Hioki, Makoto Nakashima, Masanori Yamamoto, Kensuke Takagi, Motoharu Araki, Norio Tada, Shinichi Shirai, Futoshi Yamanaka, Kentaro Hayashida
OBJECTIVES: This study aimed to analyze the prognostic impact of low-flow (LF) severe aortic stenosis in small-body patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Western literature demonstrates a poor prognosis with paradoxical LF and low-flow low-gradient (LF-LG) severe aortic stenosis (AS), as defined by stroke volume index (SVi) <35 ml/m(2) and mean pressure gradient <40 mm Hg with preserved left ventricular ejection fraction (LVEF)...
May 11, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28527962/resolution-of-mitral-regurgitation-with-left-ventricular-assist-device-support
#17
Matthew Goodwin, Hassan W Nemeh, Jamil Borgi, Gaetano Paone, Jeffrey A Morgan
BACKGROUND: Cardiac valve disease is common in patients with end-stage heart failure undergoing left ventricular assist device implantation (LVAD). The aim of this study was to determine if preoperative mitral regurgitation (MR) affects outcomes and hemodynamics in patients after LVAD implantation. METHODS: From March 2006 through May 2015, 238 consecutive patients underwent LVAD implantation. Patient cohorts included less than moderate to severe MR (< moderate-severe, n = 195) and greater than or equal to moderate to severe MR (≥ moderate-severe, n = 43)...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527865/mechanism-of-atrial-functional-mitral-regurgitation-in-patients-with-atrial-fibrillation-a-study-using-three-dimensional-transesophageal-echocardiography
#18
Kazato Ito, Yukio Abe, Yosuke Takahashi, Yoshihisa Shimada, Hitoshi Fukumoto, Yoshiki Matsumura, Takahiko Naruko, Toshihiko Shibata, Minoru Yoshiyama, Junichi Yoshikawa
BACKGROUND: Functional mitral regurgitation (MR) can occur in patients with atrial fibrillation (AF) despite having preserved left ventricular (LV) systolic function. This MR is known as atrial functional MR. The aim of this study was to clarify the mechanism of atrial functional MR using real-time three-dimensional transesophageal echocardiography (3DTEE). METHODS: Sixty patients underwent transthoracic echocardiography and 3DTEE: 16 patients with AF and significant non-organic MR and preserved LV ejection fraction (>50%) constituted the AF-MR group, 20 patients with AF and no significant MR formed the AF-NSMR group, and 24 normal subjects comprised the control group...
May 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28527109/erratum-to-clinical-pharmacokinetics-of-sacubitril-valsartan-lcz696-a-novel-angiotensin-receptor-neprilysin-inhibitor
#19
Surya Ayalasomayajula, Thomas Langenickel, Parasar Pal, Sreedevi Boggarapu, Gangadhar Sunkara
Sacubitril/valsartan (LCZ696) is indicated for the treatment of heart failure with reduced ejection fraction. Absorption of sacubitril/valsartan and conversion of sacubitril (prodrug) to sacubitrilat (neprilysin inhibitor) was rapid with maximum plasma concentrations of sacubitril, sacubitrilat, and valsartan (angiotensin receptor blocker) reaching within 0.5, 1.5-2.0, and 2.0-3.0 h, respectively. With a twofold increase in dose, an increase in the area under the plasma concentration-time curve was proportional for sacubitril, ~1...
May 19, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28527022/comparison-of-echocardiographic-parameters-to-assess-right-ventricular-function-in-pulmonary-hypertension
#20
Hirohisa Amano, Shichiro Abe, Suguru Hirose, Ryutaro Waku, Taiki Masuyama, Masashi Sakuma, Shigeru Toyoda, Isao Taguchi, Teruo Inoue, Chuwa Tei
Although measurement of right ventricular ejection fraction (RVEF) may be relevant for evaluation of therapeutic efficacy and/or prognosis in patients with pulmonary hypertension, RVEF obtained by echocardiography has limited accuracy. In contrast, radionuclide and/or magnetic resonance imaging can measure RVEF more reliably. In this study, we investigated the relationship between RVEF measured by radionuclide angiography and the echocardiographic parameters that are recommended by the American Society of Echocardiography as representative of right heart function...
May 19, 2017: Heart and Vessels
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