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https://www.readbyqxmd.com/read/27935648/cardiac-allograft-vasculopathy-after-heart-transplantation-is-it-really-ominous
#1
Ju Yong Lim, Sung Ho Jung, Min Seok Kim, Jeong-Jun Park, Tae-Jin Yun, Jae Joong Kim, Jae Won Lee
OBJECTIVES: Cardiac allograft vasculopathy (CAV) remains a major impediment to long-term survival after heart transplantation (HT). We investigated the incidence, disease course, and risk factors for CAV. METHODS: Among 399 patients who underwent HT between November 1992 and July 2014, 297 survivors were reviewed. Endpoints were CAV development and the composite outcome of death or re-HT. RESULTS: During 5.6±5.2 years, CAV was detected in 54 patients; 45 (83...
December 9, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27934810/effect-of-hypertension-at-presentation-on-prognosis-in-patients-with-dilated-cardiomyopathy-presenting-with-normal-renal-angiogram
#2
Swetha Balije, Ashutosh Kumar, Goru Bhawani, Kasturi S N Murthy, Neera Kumari
BACKGROUND & OBJECTIVES: Dilated cardiomyopathy (DCM) is a progressive disease of heart with systolic and diastolic dysfunction carrying a poor long-term prognosis. The prognostic index and predictors of mortality are considered to be useful in guiding the treatment. This study was undertaken to evaluate the effects of hypertension at presentation on prognosis in patients with DCM presenting with normal renal and coronary angiogram. METHODS: An observational, analytical, non-interventional and a combination of retrospective and prospective study was conducted in patients between 15 and 75 yr of age with DCM having on and off symptoms while receiving treatment in a cardiology outpatient department for more than a year...
August 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27932425/scn2b-deletion-in-mice-results-in-ventricular-and-atrial-arrhythmias
#3
Yangyang Bao, B Cicero Willis, Chad R Frasier, Luis F Lopez-Santiago, Xianming Lin, Roberto Ramos-Mondragón, David S Auerbach, Chunling Chen, Zhenxun Wang, Justus Anumonwo, Héctor H Valdivia, Mario Delmar, José Jalife, Lori L Isom
BACKGROUND: Mutations in SCN2B, encoding voltage-gated sodium channel β2-subunits, are associated with human cardiac arrhythmias, including atrial fibrillation and Brugada syndrome. Because of this, we propose that β2-subunits play critical roles in the establishment or maintenance of normal cardiac electric activity in vivo. METHODS AND RESULTS: To understand the pathophysiological roles of β2 in the heart, we investigated the cardiac phenotype of Scn2b null mice...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27932136/prognostic-value-of-high-sensitivity-troponin-t-to-identify-patients-at-risk-of-left-ventricular-graft-dysfunction-after-heart-transplantation
#4
A B Méndez, J Ordonez-Llanos, S Mirabet, J Galan, M L Maestre, V Brossa, M T Rivilla, L López, T Koller, A Sionis, E Roig
Primary graft dysfunction after heart transplantation (HTx) has a very high mortality rate, especially if the left ventricle (PGD-LV) is involved. Early diagnosis is important to select the appropriate therapy to improve prognosis. The value of high-sensitivity troponin T (HS-TNT) measurement obtained at patient arrival at the intensive care unit was analyzed in 71 HTx patients. Mild or moderate PGD-LV was defined by hemodynamic compromise with one of the following criteria: left ventricular ejection fraction <40%, hemodynamic compromise with right atrial pressure >15 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, cardiac index <2...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931609/clinical-and-biological-insights-into-combined-post-and-pre-capillary-pulmonary-hypertension
#5
Tufik R Assad, Anna R Hemnes, Emma K Larkin, Andrew M Glazer, Meng Xu, Quinn S Wells, Eric H Farber-Eger, Quanhu Sheng, Yu Shyr, Frank E Harrell, John H Newman, Evan L Brittain
BACKGROUND: Pulmonary hypertension (PH) is a common and morbid complication of left heart disease with 2 subtypes: isolated post-capillary pulmonary hypertension (Ipc-PH) and combined post-capillary and pre-capillary pulmonary hypertension (Cpc-PH). Little is known about the clinical or physiological characteristics that distinguish these 2 subphenotypes or if Cpc-PH shares molecular similarities to pulmonary arterial hypertension (PAH). OBJECTIVES: The goal of this study was to test the hypothesis that the hemodynamic and genetic profile of Cpc-PH would more closely resemble PAH than Ipc-PH...
December 13, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27931092/the-influence-of-race-and-common-genetic-variations-on-outcomes-after-pediatric-heart-transplantation
#6
D J Green, M M Brooks, G J Burckart, R E Chinnock, C Canter, L J Addonizio, D Bernstein, J K Kirklin, D C Naftel, D M Girnita, A Zeevi, S A Webber
Significant racial disparity remains in the incidence of unfavorable outcomes following heart transplantation. We sought to determine which pediatric post-transplantation outcomes differ by race and whether these can be explained by recipient demographic, clinical, and genetic attributes. Data were collected for 80 black and 450 non-black pediatric recipients transplanted at 1 of 6 centers between 1993 and 2008. Genotyping was performed for 20 candidate genes. Average follow-up was 6.25 years. Unadjusted five-year rates for death (p=0...
December 8, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27931082/pharmacotherapeutic-considerations-for-individuals-with-down-syndrome
#7
Erik J Hefti, Javier G Blanco
Down syndrome (DS, trisomy 21) is the most common survivable disorder due to aneuploidy. Individuals with DS may experience multiple comorbid health problems including congenital heart defects, endocrine abnormalities, skin and dental problems, seizure disorders, leukemia, dementia, and obesity. These associated conditions may necessitate pharmacotherapeutic management with various drugs. The complex pathobiology of DS may alter drug disposition and drug response in some individuals. For example, reports have documented increased rates of adverse drug reactions in patients with DS treated for leukemia and dementia...
December 8, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27931078/advanced-refractory-heart-failure-conservative-or-interventional-approach
#8
Fabio Rigamonti, Fabrizio Montecucco, Luca Liberale
The 2017 ESCI Award for the Best Clinical Research Article goes to the study by Christopher Adlbrecht and co-workers, entitled "Outcome of conservative management vs. assist device implantation in patients with advanced refractory heart failure" [1]. This article was selected among seven finalist articles of outstanding quality and scientific impact [2-7]. This article is protected by copyright. All rights reserved.
December 8, 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27931056/-guideline-s2k-awmf-of-the-deutsche-gesellschaft-f%C3%A3-r-pneumologie-und-beatmungsmedizin-and-the-deutsche-gesellschaft-f%C3%A3-r-arbeitsmedizin-und-umweltmedizin-diagnostics-and-expert-opinion-in-the-occupational-disease-no-4101-silicosis-including-coal-worker-s-pneumoconiosis
#9
X Baur, M Heger, R M Bohle, K G Hering, K Hofmann-Preiß, D Nowak, A Tannapfel, H Teschler, T Voshaar, T Kraus
During the last 1.5 years an update of the guideline on silicosis was made by an interdisciplinary working group. New medical and scientific knowledge and the experience in expert opinion practice were taken into account.By preparing the initial guideline in 2010 standardization of diagnostics and adaption of the "Moers convention" which was not based on medical knowledge was in the focus, whereas the current update deals with fine emendation and extension, especially of the compensation rate (adaption with the Reichenhall recommendation)...
December 2016: Pneumologie
https://www.readbyqxmd.com/read/27931011/cardiac-dysfunction-of-pulmonary-artery-aneurysm-in-patients-with-pulmonary-arterial-hypertension
#10
Konomi Sakata, Toru Satoh, Aoi Isaka, Yoichiro Uesugi, Mitsufumi Furuya, Kenichi Matsushita, Hideaki Yoshino
BACKGROUND: Pulmonary artery aneurysm (PAA) occurs in some patients with pulmonary arterial hypertension (PAH). We evaluated the characteristics of cardiac dysfunction in patients with PAH complicated by PAA. METHODS: Echocardiography and right-heart catheterization were performed in 130 PAH patients to measure the maximum dimensions of the main pulmonary artery (MPA) trunk and evaluate right ventricular (RV) and left ventricular (LV) function. RESULTS: A diameter of >40mm was defined as PAA in the MPA trunk...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27930603/strategies-to-improve-the-efficacy-of-epicardial-linear-ablation-on-the-beating-heart
#11
Yoshiyuki Watanabe, Matthew R Schill, Toshinobu Kazui, Spencer J Melby, Richard B Schuessler, Ralph J Damiano
OBJECTIVE: Creating transmural linear lesions on the beating heart is an important component of minimally invasive surgical ablation for atrial fibrillation. Animal studies have shown poor efficacy for surface bipolar radiofrequency ablation (RFA). Clinicians have developed strategies including multiple device applications and vena caval occlusion (VCO) to improve ablation efficacy. These techniques were evaluated in an acute porcine model. METHODS: In the first experiment, an RFA device was used to perform two 40-second epicardial ablations on the right atrium of six pigs...
December 7, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27928594/pulmonary-hypertension-in-rheumatic-mitral-stenosis-revisited
#12
L Pourafkari, S Ghaffari, M Ahmadi, A Tajlil, N Aslanabadi, N D Nader
BACKGROUND: In patients with mitral stenosis (MS), pulmonary hypertension (PH) is a significant contributor to the associated morbidity. We aimed to study factors associated with the presence of significant PH (sPH) and whether incorporating body surface area (BSA) in the mitral valve area (MVA) would improve the predictive value of the latter. METHODS: The medical records of 558 patients with severe MS undergoing percutaneous balloon mitral commissurotomy were evaluated over a period of 8 years...
December 7, 2016: Herz
https://www.readbyqxmd.com/read/27928261/iatrogenic-diversion-of-inferior-vena-cava-into-left-atrium-after-surgery-for-a-rare-combination-of-congenital-heart-diseases
#13
Feridoun Sabzi
Atrial septal defect (ASD) is a common congenital anomaly that has low surgical mortality and morbidity. We report a very rare case of a low-lying ASD, combined with the drainage of the inferior vena cava and the left superior vena cava into the left atrium. This combination was associated with an unroofed coronary sinus. We also describe an iatrogenic surgical diversion of the inferior vena cava into the left atrium with its complication. The patient presented with moderate cyanosis and was referred for elective ASD repair...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27928258/evaluation-of-pulse-oximetry-in-the-early-detection-of-cyanotic-congenital-heart-disease-in-newborns
#14
Amir Hosein Movahedian, Ziba Mosayebi, Setareh Sagheb
Background: Delayed or missed diagnosis of critical and cyanotic congenital heart disease (CHD) in asymptomatic newborns may result in significant morbidity and mortality. The aim of this study was to determine the accuracy of pulse oximetry screening performed on the first day of life for the early detection of critical and cyanotic CHD in apparently normal newborns. Methods: This cross-sectional study used postductal pulse oximetry to evaluate term neonates born between 2008 and 2011 with normal physical examinations...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27928144/long-term-clinical-outcomes-and-prognostic-factors-after-pericardiectomy-for-constrictive-pericarditis-in-a-japanese-population
#15
Shunsuke Nishimura, Chisato Izumi, Masashi Amano, Sari Imamura, Naoaki Onishi, Yodo Tamaki, Soichiro Enomoto, Makoto Miyake, Toshihiro Tamura, Hirokazu Kondo, Kazuaki Kaitani, Kazuo Yamanaka, Yoshihisa Nakagawa
BACKGROUND: Constrictive pericarditis (CP) is characterized by impaired diastolic cardiac function leading to heart failure. Pericardiectomy is considered effective treatment for CP, but data on long-term clinical outcomes after pericardiectomy are limited.Methods and Results:We retrospectively investigated 45 consecutive patients (mean age, 59±14 years) who underwent pericardiectomy for CP. Preoperative clinical factors, parameters of cardiac catheterization, and cardiac events were examined...
December 8, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27926994/microvessels-of-the-heart-formation-regeneration-and-dysfunction
#16
Ioakim Spyridopoulos, Helen M Arthur
This issue of Microcirculation focusses on the special topic of "microvessels of the heart" and contains five state-of-the-art reviews and one expert article that reflect current efforts to address the major gaps in our understanding of these key microvessels. In the adult heart, most attention until recently (especially among the clinical cardiology community) has been given to the main coronary arteries, which are the culprit vessels in patients with coronary artery disease, including its most serious manifestation, acute myocardial infarction (MI)...
December 7, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/27925367/transient-severe-tricuspid-regurgitation-after-transplantation-of-an-extremely-oversized-donor-heart-in-a-child-does-size-matter-a-case-report
#17
J Birnbaum, S M Ulrich, R Schramm, C Hagl, A Lehner, M Fischer, N A Haas, B Heineking
In pediatric heart transplantation, the size of the donor organ is an important criterion for organ allocation. Oversized donor hearts are often accepted with good results, but some complications in relation to a high donor-recipient ratio have been described. Our patient was transplanted for progressive heart failure in dilated cardiomyopathy. The donor-to-recipient weight ratio was 3 (donor weight 65 kg, recipient weight 22 kg). The intra-operative echocardiography before chest closure showed excellent cardiac function, no tricuspid valve regurgitation, and a normal central venous pressure...
December 7, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27925364/discriminatory-ability-of-right-atrial-volumes-with-two-and-three-dimensional-echocardiography-to-detect-elevated-right-atrial-pressure-in-pulmonary-hypertension
#18
Ellen Ostenfeld, Anna Werther-Evaldsson, Henrik Engblom, Annika Ingvarsson, Anders Roijer, Carl Meurling, Johan Holm, Göran Rådegran, Marcus Carlsson
AIMS: Pulmonary hypertension (PH) patients have high mortality due to right ventricular failure. Predictors of poor prognostic outcome are increased right atrial volume (RAV) and elevated mean right atrial pressure (mRAP). Our aim was to determine whether RAV measured with 2D echocardiography (2DE) and 3D echocardiography (3DE) can detect elevated mRAP in patients evaluated for PH. METHODS: Of 85 patients prospectively evaluated for PH, 44 patients (63 ± 15 years, 57% female) had 2DE, 3DE and right heart catheterization within 48 h and were in sinus rhythm...
December 7, 2016: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/27925329/fragmented-qrs-is-a-novel-risk-factor-for-ventricular-arrhythmic-events-after-receiving-cardiac-resynchronization-therapy-in-non-ischemic-cardiomyopathy
#19
Miyako Igarashi, Hiroshi Tada, Hiro Yamasaki, Kenji Kuroki, Tomoko Ishizu, Yoshihiro Seo, Takeshi Machino, Nobuyuki Murakoshi, Yukio Sekiguchi, Yuichi Noguchi, Akihiko Nogami, Kazutaka Aonuma
INTRODUCTION: A fragmented QRS (fQRS) is reported to be associated with a poor prognosis or sudden cardiac death (SCD) in patients with Brugada syndrome or ischemic heart disease. However, no studies have clarified the impact of the presence of an fQRS on SCD or ventricular arrhythmic events in patients receiving cardiac resynchronization therapy (CRT). This study aimed to clarify this point in patients with non-ischemic cardiomyopathy. METHODS AND RESULTS: This study included 137 heart failure patients with non-ischemic cardiomyopathy who received CRT (NYHA functional class: II/III/IV = 25/84/28)...
December 7, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27923944/membrane-oxygenator-use-with-biventricular-assist-device-facilitation-of-support-and-lung-recovery
#20
Kristen Nelson-McMillan, William J Ravekes, William R Thompson, Kristen M Brown, Larry Wolff, Rajeev S Wadia, LeAnn M McNamara, Donald H Shaffner, Ivor D Berkowitz, Marshall L Jacobs, Luca A Vricella
We present the use of a low-resistance membrane oxygenator (Quadrox D, Maquet) in series with a pulsatile right ventricular assist device (Berlin Heart EXCOR, Berlin Heart) in a patient with biventricular support who required high-frequency oscillatory ventilation (HFOV), due to refractory acute respiratory distress syndrome associated with Cytomegalovirus pneumonia. The high mean airway pressure associated with the use of HFOV resulted in a significant negative impact on left ventricular assist device (LVAD) filling that led to a combined respiratory and metabolic acidosis and the need for vasopressor support...
December 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
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