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https://www.readbyqxmd.com/read/28087362/clinical-phenotypes-and-outcomes-of-heritable-and-sporadic-pulmonary-veno-occlusive-disease-a-population-based-study
#1
David Montani, Barbara Girerd, Xavier Jaïs, Marilyne Levy, David Amar, Laurent Savale, Peter Dorfmüller, Andrei Seferian, Edmund M Lau, Mélanie Eyries, Jérôme Le Pavec, Florence Parent, Damien Bonnet, Florent Soubrier, Elie Fadel, Olivier Sitbon, Gérald Simonneau, Marc Humbert
BACKGROUND: Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS: We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases)...
January 10, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28087158/echocardiographic-approach-to-cardiac-tamponade-in-critically-ill-patients
#2
REVIEW
Peter McCanny, Frances Colreavy
Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. Diagnostic sensitivity of transthoracic echocardiography is dependent on image quality, and in some cases a transoesophageal approach may be required to confirm the diagnosis. Knowledge of the pathophysiology and echocardiographic features of cardiac tamponade are essential for the practicing Intensivist...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28079557/dobutamine-aggravates-haemodynamic-deterioration-induced-by-pleural-effusion-a-randomised-controlled-porcine-study
#3
Kristian B Wemmelund, Anders H Sørensen, Viktor K Ringgård, Erik Sloth, Peter Juhl-Olsen
BACKGROUND: Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. OBJECTIVE: We hypothesised that dobutamine would affect the physiological determinants preload, afterload, contractility and changes of inferior vena cava characteristics during experimental pleural effusion. DESIGN: A randomised, controlled laboratory study. SETTING: Animal laboratory, conducted from March 2013 to May 2013...
January 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#4
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28077762/inverse-problems-in-reduced-order-models-of-cardiovascular-haemodynamics-aspects-of-data-assimilation-and-heart-rate-variability
#5
Sanjay Pant, Chiara Corsini, Catriona Baker, Tain-Yen Hsia, Giancarlo Pennati, Irene E Vignon-Clementel
Inverse problems in cardiovascular modelling have become increasingly important to assess each patient individually. These problems entail estimation of patient-specific model parameters from uncertain measurements acquired in the clinic. In recent years, the method of data assimilation, especially the unscented Kalman filter, has gained popularity to address computational efficiency and uncertainty consideration in such problems. This work highlights and presents solutions to several challenges of this method pertinent to models of cardiovascular haemodynamics...
January 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#6
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077469/risk-factors-for-excess-mortality-in-adults-with-congenital-heart-diseases
#7
Jose Maria Oliver, Pastora Gallego, Ana Elvira Gonzalez, Diego Garcia-Hamilton, Pablo Avila, Raquel Yotti, Ignacio Ferreira, Francisco Fernandez-Aviles
AIMS: To examine factors related to excess mortality in a cohort of adults with congenital heart disease (CHD). METHODS AND RESULTS: We conducted a survival analysis using prospective data of 3311 adults with CHD [50.5% males, median age at entry 22.5 years (IQR 18-39), median follow-up time 10.5 years (IQR: 4.4-18)]. Survival status of each patient was further verified by cross checking with the Spanish National Death Index. During a total follow-up of 37608 person-years, 336 (10%) patients died...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28077468/integrated-imaging-of-echocardiography-and-computed-tomography-to-grade-mitral-regurgitation-severity-in-patients-undergoing-transcatheter-aortic-valve-implantation
#8
Philippe J van Rosendael, Suzanne E van Wijngaarden, Vasileios Kamperidis, William K F Kong, Melissa Leung, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
AIMS: Quantitative mitral regurgitation (MR) grading remains challenging. This study evaluated the concept of integrating echocardiography and computed tomography for grading MR severity. Specifically, an integrated parameter was developed that combines the true cross-sectional mitral regurgitant orifice area (ROA) assessed with multi-detector row computed tomography (MDCT) with flow data from echocardiography. METHODS AND RESULTS: Systolic MDCT data of 73 patients, referred for transcatheter aortic valve implantation (TAVI) who also had MR, were evaluated...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28077189/cardiac-haemangioma-associated-with-a-duct-dependent-congenital-heart-disease-in-a-newborn-infant
#9
Stefan A Djordjevic, Sofija Glumac, Jasna Kalanj
Cardiac haemangiomas are exceedingly rare; however, they can cause significant haemodynamic impairment and disturbances in heart rhythm. Rarely, cardiac tumours may also coexist with congenital heart lesions. We present an extremely unusual case of a cardiac haemangioma in the setting of complex transposition of the great arteries that caused functional tricuspid atresia. To our knowledge, this is the first such case described in the literature.
January 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28077182/functional-tricuspid-stenosis-a-rare-presentation-of-suspected-rhabdomyoma-as-congenital-cyanotic-heart-disease
#10
Anishkumar Nair, Gopalan Nair Rajesh, Chakanalil Govindan Sajeev
Cardiac tumours in newborns are often asymptomatic and can be sporadically detected on routine screening unless they result in intractable arrhythmias or haemodynamically significant obstructions causing heart failure. Their presentation as a cause of congenital cyanosis is never anticipated. We report a rare case of a newborn presenting with congenital cyanosis consequent to suspected cardiac rhabdomyoma causing tricuspid inflow obstruction. Our experience with this patient with two large cardiac masses illustrates the significance of its inclusion in the differential diagnosis of perinatal cyanosis, as early detection and surgical management might be the only lifesaving options, if performed well in time...
January 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#11
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28075423/effects-of-device-guided-slow-breathing-training-on-exercise-capacity-cardiac-function-and-respiratory-patterns-during-sleep-in-male-and-female-patients-with-chronic-heart-failure
#12
Kalina Kawecka-Jaszcz, Grzegorz Bilo, Tomasz Drożdż, Dorota Dębicka-Dąbrowska, Grzegorz Kiełbasa, Gabriella Malfatto, Katarzyna Styczkiewicz, Carolina Lombardi, Agnieszka Bednarek, Sabrina Salerno, Danuta Czarnecka, Gianfranco Parati
INTRODUCTION    Slow breathing training (SBT) has been proposed as new non-pharmacological treatment in chronic heart failure (CHF) patients.  OBJECTIVES    The aim of this study was to assess the effects of SBT on exercise capacity, haemodynamic parameters and sleep respiratory patterns in a relatively large sample of CHF patients. PATIENTS ABD METHODS    A cross-over open study was conducted. The patients completed, in random order, 10-12 week periods of SBT with the RESPeRATE device (InterCure Ltd...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#13
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#14
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28070330/the-approximated-cardiovascular-reserve-index-complies-with-haemorrhage-related-hemodynamic-deterioration-pattern-a-swine-exsanguination-model
#15
Roy Nadler, Elon Glassberg, Itay E Gabbay, Linn Wagnert-Avraham, Gal Yaniv, David Kushnir, Arik Eisenkraft, Ben-Zion Bobrovsky, Uri Gabbay
BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHODS: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#16
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28064153/comparison-of-valve-performance-of-the-mechanically-expanding-lotus-and-the-balloon-expanded-sapien3-transcatheter-heart-valves-an-observational-study-with-independent-core-laboratory-analysis
#17
Osama I I Soliman, Nahid El Faquir, Ben Ren, Ernest Spitzer, Lennart van Gils, Hans Jonker, Marcel L Geleijnse, Gerrit-Anne van Es, Jan G Tijssen, Nicolas M van Mieghem, Peter P T de Jaegere
AIMS: The Lotus and SAPIEN3 are second-generation transcatheter heart valves, which are designed to minimize paravalvular aortic regurgitation (PAR) after transcatheter aortic valve replacement (TAVR). We sought to compare both devices for valve performance and with emphasis on PAR by independent core laboratory analysis. METHODS AND RESULTS: A total of 162 (79 Lotus and 83 SAPIEN3) consecutive patients (51% female, 80 ± 8 years, Logistic EuroSCORE 14.8 ± 9...
January 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28062567/short-term-high-fat-diet-compromises-myocardial-function-a-radial-strain-rate-imaging-study
#18
Julien Ternacle, Feng Wan, Daigo Sawaki, Mathieu Surenaud, Maria Pini, Raquel Mercedes, Laura Ernande, Etienne Audureau, Jean-Luc Dubois-Rande, Serge Adnot, Sophie Hue, Gabor Czibik, Genevieve Derumeaux
AIM: Long-term high-fat diet (HFD) induces both cardiac remodelling and myocardial dysfunction in murine models. The aim was to assess the time course and mechanisms of metabolic and cardiac modifications induced by short-term HFD in wild-type (WT) mice. METHODS AND RESULTS: Thirty-three WT mice were subjected to HFD (60% fat, n = 16) and chow diet (CD, 13% fat, n = 17). Metabolic and echocardiographic data were collected at baseline and every 5 weeks for 20 weeks...
January 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28062514/cardiopulmonary-exercise-testing-for-detecting-pulmonary-arterial-hypertension-in-systemic-sclerosis
#19
Daniel Dumitrescu, Christian Nagel, Gabor Kovacs, Tom Bollmann, Michael Halank, Jörg Winkler, Martin Hellmich, Ekkehard Grünig, Horst Olschewski, Ralf Ewert, Stephan Rosenkranz
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a devastating disease with limited survival and occurs as a frequent complication in patients with systemic sclerosis (SSc). A definite diagnosis of PAH is obtained by right heart catheterisation (RHC); however, the initial suspicion is raised by non-invasive methods. We assessed the diagnostic accuracy of key parameters derived from cardiopulmonary exercise testing (CPET) for detecting and ruling out SSc-associated PAH. METHODS: In a multicentre setting, we prospectively evaluated 173 consecutive patients with SSc without known PAH, but with clinical suspicion of PAH...
January 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28058856/effective-treatment-with-a-new-protocol-using-tissue-type-plasminogen-activator-thrombolysis-for-pump-thrombosis-with-the-hvad-device
#20
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
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