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https://www.readbyqxmd.com/read/29148290/single-centre-experience-with-the-impella-cp-5-0-and-rp-in-109-consecutive-patients-with-profound-cardiogenic-shock
#1
Peter Blom Jensen, Sigrun Høegholm Kann, Karsten Tange Veien, Ole Kristian Møller-Helgestad, Jordi Sanchez Dahl, Charlotte Svejstrup Rud, Marianne Kjær Jensen, Lisette Okkels Jensen, Henrik Schmidt, Jacob Eifer Møller
RATIONALE: Short-term mechanical circulatory support is increasingly used in the management of cardiogenic shock, but data from controlled studies are sparse. Thus, real-life data on complication rates and predictors of adverse outcome are important. OBJECTIVE: The objective of this study was to analyse the experience with Impella devices in the management of profound cardiogenic shock. METHODS AND RESULTS: A retrospective study of 109 consecutive patients with severe shock after myocardial infarction, acute heart failure, or cardiac surgery...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29147476/sudden-cardiac-arrest-as-a-rare-presentation-of-myxedema-coma-case-report
#2
Divya Salhan, Deepak Sapkota, Prakash Verma, Saroj Kandel, Omar Abdulfattah, Antony Lixon, Deribe Zwenge, Frances Schmidt
Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146614/heart-rate-reduction-improves-biventricular-function-and-interactions-in-experimental-pulmonary-hypertension
#3
Olga Gomez, Kenichi Okumura, Osami Honjo, Mei Sun, Ryo Ishii, Bart Bijens, Mark K Friedberg
OBJECTIVES: To investigate mechanisms of heart rate (HR) reduction on biventricular function and interactions in experimental pulmonary arterial hypertension (PAH). METHODS: We compared cardiac-cycle mechanics and interventricular interactions in 15 sham, 8 monocrotaline-PAH, 9 PAH+carvedilol and 8 PAH+ivabradine rats. We used echocardiography to assess biventricular function, timing of cardiac- cycle events and septal position in PAH rats; and related HR reduction effect on biventricular function measured by echocardiography and conductance catheter...
November 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29142756/usefulness-of-central-venous-saturation-as-a-predictor-of-thiamine-deficiency-in-critically-ill-patients-a-case-report
#4
Genri Numata, Satoshi Kodera, Hiroyuki Kiriyama, Atsuko Nakayama, Eisuke Amiya, Arihiro Kiyosue, Masaru Hatano, Eiki Takimoto, Masafumi Watanabe, Issei Komuro
Background: Central venous oxygen saturation (ScvO2) reflects the balance of oxygen delivery and consumption. Low ScvO2 indicates the presence of inadequate oxygen delivery, while high ScvO2 indicates reduced oxygen consumption and is sometimes associated with a high mortality rate in critically ill patients from dysoxia. Thiamine is an essential cofactor in cellular aerobic metabolism. Thiamine deficiency is more prevalent than was previously thought, and underlies severe conditions in critically ill patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29142091/physiological-and-pathophysiological-firing-properties-of-single-postganglionic-sympathetic-neurons-in-humans
#5
Vaughan G Macefield, B Gunnar Wallin
It has long been known from microneurographic recordings in human subjects that activity of postganglionic sympathetic axons occurs as spontaneous bursts, with muscle sympathetic nerve activity (MSNA) exhibiting strong cardiac rhythmicity via the baroreflex and skin sympathetic nerve activity (SSNA) showing much weaker cardiac modulation. Here we review the firing properties of single sympathetic neurons, obtained using highly selective microelectrodes. Individual vasoconstrictor neurons supplying muscle or skin, or sudomotor neurones supplying sweat glands, always discharge with a low firing probability (~30%) and at very low frequencies (~0...
November 15, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o2-saturation-in-cardiac-surgery-patients-following-extubation
#6
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (SvO2) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2) or an increase in global O2 consumption ([Formula: see text]O2). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29141185/increased-cross-bridge-recruitment-contributes-to-transient-increase-in-force-generation-beyond-maximal-capacity-in-human-myocardium
#7
Nima Milani-Nejad, Jae-Hoon Chung, Benjamin D Canan, Vadim V Fedorov, Bryan A Whitson, Ahmet Kilic, Peter J Mohler, Paul M L Janssen
Cross-bridge attachment allows force generation to occur, and rate of tension redevelopment (ktr) is a commonly used index of cross-bridge cycling rate. Tension overshoots have been observed briefly after a slack-restretch ktr maneuver in various species of animal models and humans. In this study, we set out to determine the properties of these overshoots and their possible underlying mechanism. Utilizing human cardiac trabeculae, we have found that tension overshoots are temperature-dependent and that they do not occur at resting states...
November 12, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29139031/in-vivo-analysis-of-the-anti-atrial-fibrillatory-proarrhythmic-and-cardiodepressive-profiles-of-dronedarone-as-a-guide-for-safety-pharmacological-evaluation-of-antiarrhythmic-drugs
#8
Yoshiyuki Motokawa, Yuji Nakamura, Mihoko Hagiwara-Nagasawa, Ai Goto, Koki Chiba, Nur Jaharat Lubna, Hiroko Izumi-Nakaseko, Kentaro Ando, Atsuhiko T Naito, Hiroshi Yamazaki, Atsushi Sugiyama
Anti-atrial fibrillatory, proarrhythmic and cardiodepressive profiles of dronedarone were analyzed using the halothane-anesthetized beagle dogs (n = 4) to create a standard protocol for clarifying both efficacy and adverse effects of anti-atrial fibrillatory drugs. Intravenous administration of dronedarone hydrochloride in doses of 0.3 and 3 mg/kg over 30 s attained the peak plasma concentrations of 61 and 1248 ng/mL, respectively, reflecting sub- to supra-therapeutic ones. The low dose decreased the left ventricular contraction and mean blood pressure, which were enhanced at the high dose...
November 14, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#9
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29136335/sii-ang-ii-potentiates-insulin-receptor-signalling-and-glycogen-synthesis-in-hepatocytes
#10
Samra Joke Sanni, Christina Lyngsø, Steen Gammeltoft, Jakob Lerche Hansen
The angiotensin II type I receptor (AT1R) is involved in the regulation of cardiovascular function. Excessive activation of AT1R by angiotensin II (Ang II) leads to cardiovascular disease and may be involved in the development of insulin resistance and diabetes. Functionally selective Ang II analogues, such as the [Sar1, Ile4, Ile8]-angiotensin II (SII Ang II) analogue that only activates a subset of signalling networks have been demonstrated to have beneficial effects on cardiovascular function in certain settings, including lowering blood pressure and increasing cardiac performance...
November 14, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29132702/neutrophil-lymphocyte-ratio-prognostic-impact-in-heart-surgery-early-outcomes-and-late-survival
#11
Shuli Silberman, Ulfat Abu-Yunis, Rachel Tauber, Linda Shavit, Tal Grenader, Daniel Fink, Daniel Bitran, Ofer Merin
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) is a recognized marker of inflammation associated with poor outcomes in various clinical situations. We analyzed the prognostic significance of preoperative elevated NLR in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of 3,027 consecutive patients undergoing cardiac surgery. Receiver-operating-characteristic was used to determine the cutoff value for elevated NLR. Multivariate regression was used to determine the predictive value of preoperative NLR on clinical outcomes...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132619/a-statistical-analysis-based-recommender-model-for-heart-disease-patients
#12
Anam Mustaqeem, Syed Muhammad Anwar, Abdul Rashid Khan, Muhammad Majid
OBJECTIVES: An intelligent information technology based system could have a positive impact on the life-style of patients suffering from chronic diseases by providing useful health recommendations. In this paper, we have proposed a hybrid model that provides disease prediction and medical recommendations to cardiac patients. The first part aims at implementing a prediction model, that can identify the disease of a patient and classify it into one of the four output classes i.e., non-cardiac chest pain, silent ischemia, angina, and myocardial infarction...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132212/oil-exposure-impairs-in-situ-cardiac-function-in-response-to-%C3%AE-adrenergic-stimulation-in-cobia-rachycentron-canadum
#13
Georgina Kimberly Cox, Dane A Crossley, John D Stieglitz, Rachael M Heuer, Daniel D Benetti, Martin Grosell
Aqueous crude oil spills expose fish to varying concentrations of dissolved polycyclic aromatic hydrocarbons (PAHs), which can have lethal and sub-lethal effects. The heart is particularly vulnerable in early life stages, as PAH toxicity causes developmental cardiac abnormalities and impaired cardiovascular function. However, cardiac responses of juvenile and adult fish to acute oil exposure remain poorly understood. We sought to assess cardiac function in a pelagic fish species, the cobia (Rachycentron canadum), following acute (24 hr) exposure to two ecologically relevant levels of dissolved PAH's...
November 14, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/29131882/time-course-response-of-the-heart-and-circulatory-system-to-active-postural-changes
#14
Jo P Pauls, Llion Roberts, Tom Burgess, John/F Fraser, Shaun/D Gregory, Geoff Tansley
Rotary blood pumps (RBPs) used for mechanical circulatory support of heart failure patients cannot passively change pump flow sufficiently in response to frequent variations in preload induced by active postural changes. A physiological control system that mimics the response of the healthy heart is needed to adjust pump flow according to patient demand. Thus, baseline data is required on how the healthy heart (i.e. heart rate (HR) and cardiac output (CO)) and circulatory system (i.e. systemic vascular resistance (SVR)) respond...
November 13, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29130772/assessment-of-left-ventricular-function-using-the-myocardial-performance-index-in-term-fetuses-that-develop-intrapartum-compromise
#15
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Alexander Gooi, Sailesh Kumar
OBJECTIVE: To investigate the relationship between the prelabour left ventricular myocardial Performance Index (LVMPI) and intrapartum fetal compromise (IFC) in low risk term pregnancies. METHODS: A blinded, prospective observational cohort study at the Mater Mother's Hospital, Brisbane, Australia. A cohort of 284 women with uncomplicated singleton pregnancies underwent fortnightly ultrasound from 36 weeks until delivery. The LVMPI was assessed by conventional Doppler ultrasound and correlated with intrapartum outcomes...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29130036/accuracy-precision-and-trending-ability-of-electrical-cardiometry-cardiac-index-versus-continuous-pulmonary-artery-thermodilution-method-a-prospective-observational-study
#16
P B W Cox, A M den Ouden, M Theunissen, L J Montenij, A G H Kessels, M D Lancé, W F F A Buhre, M A E Marcus
Introduction: Evaluation of accuracy, precision, and trending ability of cardiac index (CI) measurements using the Aesculon™ bioimpedance electrical cardiometry (Aesc) compared to the continuous pulmonary artery thermodilution catheter (PAC) technique before, during, and after cardiac surgery. Methods: A prospective observational study with fifty patients with ASA 3-4. At six time points (T), measurements of CI simultaneously by continuous cardiac output pulmonary thermodilution and thoracic bioimpedance and standard hemodynamics were performed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29129185/combined-use-of-high-doses-of-vasopressin-and-corticosteroids-in-a-patient-with-crohn-s-disease-with-refractory-septic-shock-after-intestinal-perforation-a-case-report
#17
Salvatore Notaro, Marcello Sorrentino, Aniello Ruocco, Annalisa Notaro, Antonio Corcione, Patrizia Murino, Eugenio Piscitelli, Marianna Tamborino
BACKGROUND: In this article, we present a clinical case of refractory septic shock resulting from intestinal perforation treated with high doses of vasopressin and hydrocortisone during emergency surgery. The use of such high doses of vasopressin for this type of shock is not described in the literature. CASE PRESENTATION: A 49-year-old white woman with grade III obesity, Crohn's disease, and an intestinal perforation presented with refractory septic shock. Initially, a low dose of vasopressin was used...
November 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29127237/metaboreflex-mediated-hemodynamic-abnormalities-in-individuals-with-coronary-artery-disease-without-overt-signs-or-symptoms-of-heart-failure
#18
Sara Magnani, Silvana Roberto, Gianmarco Sainas, Raffaele Milia, Girolamo Palazzolo, Lucia Cugusi, Virginia Pinna, Azzurra Doneddu, Seyed Alireza Hosseini Kakhak, Filippo Tocco, Giuseppe Mercuro, Antonio Crisafulli
This study was devised to investigate the effect of coronary artery disease (CAD) without overt signs of heart failure on the cardiovascular responses to muscle metaboreflex activation. We hypothesized that any CAD-induced pre-clinical systolic and/or diastolic dysfunction could impair hemodynamic response to the metaboreflex test. Twelve males diagnosed with CAD without any sign or symptoms of heart failure and 11 age-matched healthy controls (CTL) participated in the study. Subjects performed a post-exercise muscle ischemia (PEMI) test to activate the metaboreflex...
November 10, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29127235/cardiac-performance-is-limited-by-oxygen-delivery-to-the-mitochondria-in-the-crystalloid-perfused-working-heart
#19
Sarah Kuzmiak-Glancy, Raul Covian, Armel N Femnou, Brian Glancy, Rafael Jaimes, Anastasia M Wengrowski, Kara Garrott, Stephanie French, Robert S Balaban, Matthew W Kay
The left ventricular (LV) working, crystalloid-perfused heart is used extensively to evaluate basic cardiac function, pathophysiology, and pharmacology. Crystalloid-perfused hearts may be limited by oxygen delivery, as adding oxygen carriers increases myoglobin oxygenation and improves myocardial function. However, whether decreased myoglobin oxygen saturation impacts oxidative phosphorylation (OxPhos) is unresolved since myoglobin has a much lower affinity for oxygen than cytochrome c oxidase (COX). In the present study, a laboratory-based synthesis of an affordable perfluorocarbon (PFC) emulsion was developed to increase perfusate oxygen-carrying capacity without impeding optical absorbance assessments...
November 10, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29126782/feasibility-and-limitations-of-mitral-valve-repair-with-or-without-left-ventricular-reconstruction-in-non-ischemic-dilated-cardiomyopathy
#20
Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
BACKGROUND: Although non-transplant surgical interventions for non-ischemic dilated cardiomyopathy (NIDCM) are relatively effective, their feasibility and limitations have not been fully elucidated. The aim of this study was to define the feasibility and limitations of mitral valve repair, with or without surgical ventricular reconstruction for patients with NIDCM in terms of postoperative low cardiac output syndrome (LOS). METHODS: Twenty non-transplant candidates (aged 57±13 years) with NIDCM and significant mitral regurgitation had undergone mitral valve repair combined with submitral procedures...
November 7, 2017: Journal of Cardiology
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