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https://www.readbyqxmd.com/read/27921241/introducing-transcatheter-aortic-valve-implantation-with-a%C3%A2-new-generation-prosthesis-institutional-learning-curve-and-effects-on-acute-outcomes
#1
G D'Ancona, H U Agma, S Kische, G El-Achkar, M Dißmann, J Ortak, H Ince, U Ketterer, A Bärisch, A Öner
OBJECTIVES: We present our single-centre experience with the direct flow medical (DFM) trans-catheter aortic valve implantation (TAVI) prosthesis addressing the impact of learning curve upon outcomes. BACKGROUND: The DFM has been recently introduced for TAVI. The prosthesis presents original design and implantation features. METHODS: Patients were divided into three groups according to the chronological implantation sequence that reflected technical skills acquisition of the entire team...
December 5, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27916655/allopurinol-as-a-therapeutic-option-in-cardiovascular-disease
#2
REVIEW
Osita N Okafor, K Farrington, Diana A Gorog
Epidemiological studies indicate that hyperuricaemia is an independent risk factor for cardiovascular disease. Alongside uric acid formation, increased xanthine oxidase activity also results in the formation of oxidative free radicals and superoxide particles. Oxidative stress significantly contributes to the development of cardiovascular disease, including endothelial cell dysfunction, atherosclerosis, vascular calcification and impaired myocardial energetics. Allopurinol, a competitive xanthine oxidase inhibitor, in addition to reducing serum uric acid levels, can act as a free radical scavenger...
December 1, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27915118/a-streamlined-acquisition-for-mapping-baseline-brain-oxygenation-using-quantitative-bold
#3
Alan J Stone, Nicholas P Blockley
Quantitative BOLD (qBOLD) is a non-invasive MR technique capable of producing quantitative measurements of the haemodynamic and metabolic properties of the brain. Here we propose a refinement of the qBOLD methodology, dubbed streamlined-qBOLD, in order to provide a clinically feasible method for mapping baseline brain oxygenation. In streamlined-qBOLD confounding signal contributions are minimised during data acquisition through the application of (i) a Fluid Attenuated Inversion Recovery (FLAIR) preparation to remove cerebral spinal fluid (CSF) signal contamination, (ii) a Gradient Echo Slice Excitation Profile Imaging (GESEPI) acquisition to reduce the effect of macroscopic magnetic field gradients and (iii) an Asymmetric Spin Echo (ASE) pulse sequence to directly measure the reversible transverse relaxation rate, R2'...
November 30, 2016: NeuroImage
https://www.readbyqxmd.com/read/27913801/the-pressure-reduction-coefficient-a-new-parameter-to-assess-aneurysmal-blood-stasis-induced-by-flow-diverters-disruptors
#4
Gregory Gascou, Riccardo Ferrara, Dominique Ambard, Mathieu Sanchez, Kyriakos Lobotesis, Franck Jourdan, Vincent Costalat
BACKGROUND AND PURPOSE: Pore density (PD), surface metal coverage (SMC) and the number of wires are all different parameters which can influence the efficacy of a flow disruptor/diverter. Nevertheless, the relative importance of a parameter to induce intra-aneurysmal blood stasis is still poorly evaluated. Therefore, comparison between devices based on a unique value is not reliable. The aim of this study was to propose a new bench top parameter (the pressure reduction coefficient (PRC; ξ)) in order to assess the global haemodynamic effect of each flow diverter/disruptor to slow flow...
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27910154/interferon-free-regimens-improve-portal-hypertension-and-histological-necroinflammation-in-hiv-hcv-patients-with-advanced-liver-disease
#5
P Schwabl, M Mandorfer, S Steiner, B Scheiner, D Chromy, M Herac, T Bucsics, H Hayden, K Grabmeier-Pfistershammer, A Ferlitsch, G Oberhuber, M Trauner, M Peck-Radosavljevic, T Reiberger
BACKGROUND: HIV/HCV co-infected patients show accelerated fibrosis progression and higher risk for complications of portal hypertension (PHT). AIM: To assess the effects of interferon-free therapy on portal pressure, liver histology and plasma biomarkers in HIV/HCV-coinfected patients with PHT. METHODS: Twenty-two patients with paired hepatic venous pressure gradient (HVPG) measurements prior and after successful treatment (SVR) with interferon-free regimens were included...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27909593/our-anaesthetic-experiences-in-patients-undergoing-percutaneous-mitraclip-implantation
#6
Ezgi Erkılıç, Elvin Kesimci, Cihan Döğer, Tülin Gümüş, Süleyman Ellik, Orhan Kanbak
OBJECTIVE: Percutaneous mitraclip implantation system, is a new technique developed for patients with high surgical risks. It is generally performed in a catheterisation laboratory with the guidance of fluoroscopy and transesophageal echocardiography. In this study, we aimed to share our experiences on anaesthetic in patients undergoing mitraclip implantation under general anaesthesia. METHODS: Eighty four patients with severe, symptomatic mitral insufficiency, who had undergone MitraClip implantation under general anaesthesia between July 2012 and March 2015 (54 male, 30 female; mean age: 68...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27908913/comfrey-herbal-remedy-causing-second-degree-heart-block-do-not-be-outfoxed-by-digitalis
#7
Mathew Kurian Vithayathil, Matthew Edwards
A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves...
December 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27908677/haemodynamic-variations-of-flow-to-renal-arteries-in-custom-made-and-pivot-branch-fenestrated-endografting
#8
J Ou, A Y S Tang, T L Chiu, K W Chow, Y C Chan, S W K Cheng
OBJECTIVE: This study aimed to investigate variation of blood flow to renal arteries in custom-made and pivot branch (p-branch) fenestrated endografting, using a computational fluid dynamics (CFD) technique. METHODS: Idealised models of custom-made and p-branch fenestrated grafting were constructed on a basis of a 26 mm stent graft. The custom-made fenestration was designed with a 6 mm diameter, while the 5 mm depth renal p-branch was created with a 6 mm inner and 15 mm outer fenestration...
November 28, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27908301/utility-of-b-type-natriuretic-peptides-in-the-assessment-of-patients-with-systemic-sclerosis-associated-pulmonary-hypertension-in-the-pharos-registry
#9
Lorinda Chung, Robert M Fairchild, Daniel E Furst, Shufeng Li, Firas Alkassab, Marcy B Bolster, Mary Ellen Csuka, Chris T Derk, Robyn T Domsic, Aryeh Fischer, Tracy Frech, Mardi Gomberg-Maitland, Jessica K Gordon, Monique Hinchcliff, Vivien Hsu, Laura K Hummers, Dinesh Khanna, Thomas A Jr Medsger, Jerry A Molitor, Ivana R Preston, Elena Schiopu, Lee Shapiro, Faye Hant, Richard Silver, Robert Simms, John Varga, Virginia D Steen, Roham T Zamanian
OBJECTIVES: To assess the utility of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) in detecting and monitoring pulmonary hypertension (PH) in systemic sclerosis (SSc). METHODS: PHAROS is a multicenter prospective cohort of SSc patients at high risk for developing pulmonary arterial hypertension (SSc-AR-PAH) or with a definitive diagnosis of SSc-PH. We evaluated 1) the sensitivity and specificity of BNP≥64 and NT-proBNP≥210 pg/mL for the detection of SSc-PAH and/ or SSc-PH in the SSc-AR-PAH population; 2) baseline and longitudinal BNP and NT-proBNP levels as predictors of progression to SSc-PAH and/or SSc-PH; 3) baseline BNP≥180, NT-proBNP≥553 pg/mL, and longitudinal changes in BNP and NT-proBNP as predictors of mortality in SSc-PH diagnosed patients...
November 10, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27905006/guidelines-on-the-management-of-atrial-fibrillation-in-the-emergency-department-a-critical-appraisal
#10
Giorgio Costantino, Gian Marco Podda, Lorenzo Falsetti, Primiano Iannone, Ana Lages, Alberto M Marra, Maristella Masala, Olaug Marie Reiakvam, Florentia Savva, Jan Schovanek, Sjoerd van Bree, Inês João da Silva Chora, Graziella Privitera, Silvio Ragozzino, Matthias von Rotz, Lycke Woittiez, Christopher Davidson, Nicola Montano
Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF...
November 30, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27904907/the-impact-of-cd4-cd28-null-t-lymphocytes-on-atrial-fibrillation-and-mortality-in-patients-with-chronic-heart-failure
#11
Patrick Sulzgruber, Lorenz Koller, Max-Paul Winter, Bernhard Richter, Steffen Blum, Magdalena Korpak, Martin Hülsmann, Georg Goliasch, Johann Wojta, Alexander Niessner
Atrial fibrillation (AF) represents the most common cardiac arrhythmia. Especially in patients with chronic heart failure (CHF) the development of AF represents a severe complication resulting in haemodynamic deterioration. While pro-inflammatory cytokines proved to have a pivotal role in the development and progression of both AF and CHF, less attention has been paid to the cellular immunity. Therefore we prospectively enrolled 112 patients with CHF and performed fluorescein-activated cell sorting (FACS). Patients were stratified in two subgroups according to patients presenting with AF (n=56) and patients free of AF (n=56)...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27903685/to-stress-or-not-to-stress-exercise-pulmonary-haemodynamic-testing-in-systemic-sclerosis
#12
EDITORIAL
Edmund M T Lau, Vivek Thakkar, Marc Humbert, Philippe Herve
No abstract text is available yet for this article.
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27903659/pulmonary-hypertension-the-importance-of-correctly-diagnosing-the-cause
#13
Sanjay Mehta, Jean-Luc Vachiéry
Pulmonary hypertension (PH) is a complex condition that can occur as a result of a wide range of disorders, including left heart disease, lung disease and chronic pulmonary thromboembolism. Contemporary PH patients are older and frequently have a multitude of comorbidities that may contribute to or simply coincide with their PH. Identifying the cause of PH in these complicated patients can be challenging but is essential, given that the aetiology of the disease has a significant impact on the management options available...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#14
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27900328/blunt-traumatic-tension-chylothorax-case-report-and-mini-review-of-the-literature
#15
Kamal Idris, Michael Sebastian, Ashraf F Hefny, Navidul Haq Khan, Fikri M Abu-Zidan
Tension chylothorax following blunt thoracic trauma is an extremely rare condition. Here we report such a case and review its management. A 31-year-old man was involved in a road traffic collision. The car rolled over and the patient was ejected from the vehicle. On arrival at the Emergency Department the patient was conscious and haemodynamically stable. Clinical examination of the chest and abdomen was normal. The patient had sustained fractures of the sixth cervical vertebra and the tenth thoracic vertebra, left pleural effusion, haematoma around the descending aorta and fracture of the right clavicle...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27900165/evaluation-of-cardiovascular-risk-lowering-health-benefits-accruing-from-laboratory-based-community-based-and-exercise-referral-exercise-programmes
#16
R Webb, J E S Thompson, J-S Ruffino, N A Davies, L Watkeys, S Hooper, P M Jones, G Walters, D Clayton, A W Thomas, K Morris, D H Llewellyn, M Ward, J Wyatt-Williams, B J McDonnell
BACKGROUND: To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). METHODS: Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27896596/haemodynamic-and-functional-consequences-of-the-iatrogenic-atrial-septal-defect-following-mitraclip-therapy
#17
REVIEW
E A Hart, K Zwart, A J Teske, M Voskuil, P R Stella, S A J Chamuleau, A O Kraaijeveld
Percutaneous MitraClip placement for treatment of severe mitral regurgitation in high surgical risk patients is a commonly performed procedure and requires a transseptal puncture to reach the left atrium. The resulting iatrogenic atrial septal defect (iASD) is not routinely closed, yet the haemodynamic and functional consequences of a persisting defect are not fully understood. Despite positive effects such as acute left atrial pressure relief, persisting iASDs are associated with negative consequences, namely significant bidirectional shunting and subsequent worse clinical outcome...
November 28, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27891745/cardiac-extracellular-matrix-is-associated-with-adverse-outcome-in-patients-with-chronic-heart-failure
#18
Franz Duca, Caroline Zotter-Tufaro, Andreas A Kammerlander, Adelheid Panzenböck, Stefan Aschauer, Daniel Dalos, Benedikt Köll, Benedikt Börries, Hermine Agis, Renate Kain, Klaus Aumayr, Florian Klinglmüller, Julia Mascherbauer, Diana Bonderman
AIMS: Accumulation of extracellular matrix (ECM) is known to play a crucial role in the pathophysiology of heart failure (HF). However, its prognostic relevance is poorly investigated. METHODS AND RESULTS: A total of 73 HF patients who underwent LV endomyocardial biopsy were enrolled in our study. ECM area was quantified by TissueFAXS and ImageJ software. Patients were followed-up at 6-month intervals. The study endpoint was defined as hospitalization for a cardiac reason and/or cardiac death...
November 27, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27891584/an-observational-study-of-the-macro-and-micro-haemodynamic-implications-of-epidural-anaesthesia-in-children
#19
L Triffterer, P Marhofer, G Lechner, T C Marksz, O Kimberger, W Schmid, D Marhofer
The haemodynamic implications of epidural anaesthesia in children are poorly documented. We report macro- and micro-haemodynamic data from an observational study of 25 children ranging from neonates to six-years old, who underwent surgery conducted with a specific combination of monitoring systems. We analysed 90 min of study-related monitoring after epidural catheterisation, with skin incision taking place after around 30 min. We recorded macrohaemodynamic parameters (monitored using LiDCOrapid) including heart rate, mean arterial pressure, cardiac output, stroke volume, systemic vascular resistance and stroke volume variation...
November 28, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27891427/anaesthetic-management-of-a-case-of-down-s-syndrome-with-achalasia-cardia
#20
Neeta Santha, Madhusudan Upadya, Sravanthi Vishwanatham
Achalasia cardia is a disorder of the gastrointestinal tract characterized by dilatation of the oesophagus and collection of food and fluids in the oesophagus leading to massive regurgitation and aspiration of gastric contents. Down's syndrome has multisystem effects which can also present as difficult airway. Here, we present a case of a 14-year-old girl, a case of Down's syndrome with Achalasia cardia and mitral valve prolapse posted for Heller's cardiomyotomy. Anaesthetic concerns were difficult airway due to Downs's syndrome, massive aspiration risks of Achalasia cardia and haemodynamic instability due to mitral regurgitation...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
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