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Pulmonary hypertension in renal failure patients

Ahmed M Selim, Nitasha Sarswat, Iosif Kelesidis, Muhammad Iqbal, Ramesh Chandra, Ronald Zolty
BACKGROUND: The relationship between heart failure (HF) and the serotonergic system has been established in animal studies. However, data on human plasma serotonin level in HF and its significance over the course of the disease is lacking. METHODS: Serotonin levels were measured in 173 patients (108 males, 65 females), 116 were stable HF and 40 were acute decompensated HF patients. The normal control group included 17 healthy volunteers with no known medical or psychiatric conditions...
September 17, 2016: Heart, Lung & Circulation
Osman Güvenç, Saime Sündüs Uygun, Derya Çimen, Eyüp Aslan, Ali Annagür
Jeune syndrome (Asphyxiating thoracic dysplasia) is a rare dystrophy of the skeleton, inherited as an autosomal recessive condition. Patients develop a narrowed thorax, rhizomelic dwarfism, and hepatic, renal, and pancreatic abnormalities. High rates of pulmonary hypoplasia and pulmonary hypertension have been reported. Some patients die in early stages of life due to respiratory failure. The case of a patient referred with a history of severe asphyxiating birth, who had been diagnosed with Jeune syndrome and later hypertrophic cardiomyopathy (HCM) upon echocardiographic examination is described in the present report...
September 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Mu-Yang Hsieh, Tsung-Yan Chen, Lin Lin, Min-Tsun Liao, Ren-Huei Wang, Ruei-Cheng Kuo, Chao-Lun Lai, Chih-Cheng Wu
OBJECTIVES: Right heart catheterization is an important diagnostic tool but carries risks of adverse events. Little is known about the feasibility and safety of using dialysis arteriovenous (AV) shunts. We aim to evaluate the feasibility and safety of using dialysis AV shunts for access in right heart catheterization. METHODS: Hemodialysis patients who required right heart catheterization were prospectively enrolled. A 7 Fr sheath was inserted and a balloon-tipped pulmonary artery catheter was advanced for right heart catheterization...
September 15, 2016: Journal of Invasive Cardiology
Thomas M Kelley, Mohammed Kashem, He Wang, James McCarthy, Nels D Carroll, G William Moser, T Sloane Guy
BACKGROUND: This study reported on the treatment of Carpentier type IIIa and type IIIb mitral regurgitation (MR) with a large patch anterior mitral valve leaflet augmentation technique using CorMatrix (CorMatrix Cardiovascular Inc, Alpharetta, GA) extracellular matrix (ECM). METHODS: A single-site chart review was conducted on patients who underwent anterior leaflet augmentation performed with the Da Vinci surgical robot (Intuitive Surgical, Sunnyvale, CA) or through a median sternotomy...
September 9, 2016: Annals of Thoracic Surgery
Nathalie Costedoat-Chalumeau, Laetitia Coutte, Véronique Le Guern, Nathalie Morel, Gaelle Leroux, Romain Paule, Luc Mouthon, Jean-Charles Piette
The catastrophic antiphospholipid syndrome (CAPS) develops in at least 1% of patients with antiphospholipid syndrome, either primary or associated with systemic lupus erythematosus. CAPS reveals the antiphospholipid syndrome in about 50% of cases. The CAPS is characterized by rapidly-progressive widespread thromboses mainly affecting the microvasculature in the presence of antiphospholipid antibodies. In a few days, the patients develop multiorgan failure with renal insufficiency with severe hypertension, pulmonary, cerebral, cardiac, digestive and/or cutaneous involvement...
September 9, 2016: La Presse Médicale
Masanori Mizuno, Hideo Ohuchi, Taka-Aki Matsuyama, Aya Miyazaki, Hatsue Ishibashi-Ueda, Osamu Yamada
We report multi-organ histopathological changes in a patient with protein-losing enteropathy (PLE) over 12 years after Fontan operation. A 14-year-old boy with right isomerism heart and single ventricle had undergone Fontan procedure at 19 months of age, and PLE was diagnosed at 28 months. He had several episodes of intestinal bleeding and pre-renal failure with elevated creatine, and eventually died of pneumonia. The intrapulmonary small arteries showed medial and intimal thickening resembling pulmonary hypertension...
September 11, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Jin Han, Ya Gao, Qi Guo, Dan Su, Bin Yan, Liyuan Peng, Yuxing Du, Ke Li, Gang Wang
OBJECTIVE: To investigate the relationship between the level of serum cystatin C (s-CC) and reverse-dipper blood pressure (BP) pattern. DESIGN: Cross-sectional study. SETTING: Single centre. PARTICIPANTS: A total of 718 hypertensive patients were eventually recruited from cardiac clinics between 2012 and 2014 in the Second Affiliated Hospital, Xi'an Jiaotong University. They were diagnosed as essential hypertension according to their casual office records of systolic blood pressure (SBP) and/or diastolic blood pressure (DBP)...
2016: BMJ Open
Marlous Hall, Tatendashe B Dondo, Andrew T Yan, Shaun G Goodman, Héctor Bueno, Derek P Chew, David Brieger, Adam Timmis, Phillip D Batin, John E Deanfield, Harry Hemingway, Keith A A Fox, Christopher P Gale
IMPORTANCE: International studies report a decline in mortality following non-ST-elevation myocardial infarction (NSTEMI). Whether this is due to lower baseline risk or increased utilization of guideline-indicated treatments is unknown. OBJECTIVE: To determine whether changes in characteristics of patients with NSTEMI are associated with improvements in outcomes. DESIGN, SETTING, AND PARTICIPANTS: Data on patients with NSTEMI in 247 hospitals in England and Wales were obtained from the Myocardial Ischaemia National Audit Project between January 1, 2003, and June 30, 2013 (final follow-up, December 31, 2013)...
September 13, 2016: JAMA: the Journal of the American Medical Association
Loheetha Ragupathi, Drew Johnson, Gregary D Marhefka
Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites...
August 2016: Texas Heart Institute Journal
Chung-Kuan Wu, Jyh-Gang Leu, Cheng-Chun Wei, Shih-Chung Hsieh
BACKGROUND: Acute thrombosis of a transplanted renal artery is a serious vascular complication following renal allograft transplantation, which usually occurs within the first month after transplantation and often results in graft loss. It rarely occurs beyond the first month, except in a rejected kidney or in a kidney with high-grade transplant renal artery stenosis. RESULT: A 65-year-old male with a history of type 2 diabetes mellitus, hypertension, pulmonary tuberculosis, and end-stage renal disease was previously treated with hemodialysis (HD)...
July 2016: Medicine (Baltimore)
Lisa Baumann, Susanne Haen, Christoph Berg, Ferruh Artunc, Reimer Riessen, Werner Spengler, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: We report on a 48-year-old man presenting with progressive hepatopathy and encephalopathy for two weeks based on a chronic hepatitis C. He takes ledipasvir and sofosbuvir (Harvoni) and ribavirin for almost 24 weeks. After admission to hospital his state deteriorated rapidly. He is directly transferred to the medical intensive care unit, where he died on day 3. INVESTIGATIONS: During the physical examination, a pronounced jaundice and significant peripheral edema were found...
July 2016: Deutsche Medizinische Wochenschrift
Yi-Chih Hung, Che-Chen Lin, Wei-Lun Huang, Man-Ping Chang, Ching-Chu Chen
The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio...
2016: Scientific Reports
Nicolas W Shammas, Mary F Knowles, W John Shammas, William Hauber, Gail A Shammas, Melissa J Green, Julie Dokas
BACKGROUND: The optimal technique to detect venous reflux requires a patient to be standing with weight on one leg while the other leg is scanned for superficial venous reflux (standing position [SP] technique). This represents a significant hardship for a subset of patients who are unable to stand and adequately maintain their balance. This study examines the predictability of identifying venous reflux using a reverse Trendelenburg 60° (RT-60) when compared with the SP in the great saphenous vein (GSV) and small saphenous vein (SSV)...
September 2016: Journal of Invasive Cardiology
Jurabek Babadjanov, Roy Miler, Kurt Niebauer, Lee Kirksey
Pulmonary hypertension (PH) is an increase in pulmonary arterial pressure secondary to narrowing and obliteration of the lumen of the lung vessels resulting in an increased resistance to flow. It is defined by a mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest usually confirmed by right heart catheterization compared with normal mPAP of ≤20 mmHg. The primary etiology of PH is unclear, although it can be from heart, lung or systemic disease. Patients with End-Stage Renal Disease (ESRD) are at increased risk of developing PH, with up to 39% of patients with an arteriovenous fistula developing PH [7-9,15]...
July 13, 2016: Annals of Vascular Surgery
Talna Kortchinsky, Sacha Mussot, Saïda Rezaiguia, Margaux Artiguenave, Elie Fadel, François Stephan
After bilateral lung and heart-lung transplantation in adults with pulmonary hypertension, hemodynamic and oxygenation deficiencies are life-threatening complications that are increasingly managed with extracorporeal life support (ECLS). The primary aim of this retrospective study was to assess 30-day and 1-year survival rates in patients managed with vs without post-operative venoarterial ECLS in 2008-2013. The secondary endpoints were the occurrence rates of nosocomial infection, bleeding, and acute renal failure...
September 2016: Clinical Transplantation
Kirsten Schmieder, Ulrich Keilholz, Stephanie Combs
BACKGROUND: 20-40% of patients with malignant tumors have one or more brain metastases in the course of their illness. Brain metastases are the first manifestation of cancer in 5-10%. Manifestations such as intracranial hypertension or focal neurologic deficits are seen in over 80% of patients with brain metastases. Uncertainty surrounds the treatment of patients with intracranial metastases, as the existing data are derived from trials with low levels of evidence. METHODS: This article is based on a selective literature review and on the authors' own experience of 100 consecutive patients who underwent surgery at the Department of Neurosurgery at Ruhr University Bochum (RUB), Germany...
June 17, 2016: Deutsches Ärzteblatt International
Eugenio Martelli, Diego Patacconi, Gennaro DE Vivo, Arnaldo Ippoliti
BACKGROUND: The aim of the study was to investigate the possible role of individual predisposition in the pathogenesis of carotid restenosis. METHODS: Over 1700 patients have undergone carotid endarterectomy (CEA) in our institute over the past 15 years. We retrospectively reviewed the charts of those who also had contralateral carotid stenting (CAS) for primary atherosclerotic stenosis and recorded the rates of post-CEA and post-CAS restenosis ≥50%. RESULTS: In the 29 cases analyzed (21 men/8 women), CEA was performed with conventional technique and direct suturing in most cases...
August 2016: Journal of Cardiovascular Surgery
Nils Kucher, Drahomir Aujesky, Jürg H Beer, Lucia Mazzolai, Thomas Baldi, Martin Banyai, Daniel Hayoz, Thomas Kaeslin, Wolfgang Korte, Robert Escher, Marc Husmann, Beat Frauchiger, Iris Baumgartner, David Spirk
We investigated three-month clinical outcomes in patients with venous thromboembolism (VTE) treated with rivaroxaban or conventional anticoagulation in routine clinical practice. Between November 2012 and February 2015, 2,062 consecutive patients with VTE from 11 acute care hospitals in Switzerland were enrolled in the SWIss Venous ThromboEmbolism Registry (SWIVTER). Overall, 417 (20 %) patients were treated with rivaroxaban. In comparison to 1,645 patients on conventional anticoagulation, patients on rivaroxaban were younger (56 ± 18 vs...
August 30, 2016: Thrombosis and Haemostasis
Eva Malikova, Kristina Galkova, Peter Vavrinec, Diana Vavrincova-Yaghi, Zuzana Kmecova, Peter Krenek, Jan Klimas
Renin-angiotensin system (RAS) is one of the pathophysiological mechanisms in heart failure. Recently, involvement of the kidney in the disease progression has been proposed in patients with pulmonary arterial hypertension (PAH). We hypothesized that local and systemic RAS could be the central regulators of cardiopulmonary-renal interactions in experimental monocrotaline-induced pulmonary hypertension (PH) in rats. Male 12-week-old Wistar rats were injected subcutaneously with monocrotaline (60 mg/kg). The experiment was terminated 4 weeks after monocrotaline administration...
July 2016: Molecular and Cellular Biochemistry
Cheng-Huang Shen, Cai-Mei Zheng, Kee-Thai Kiu, Hsin-An Chen, Chia-Chang Wu, Kuo-Cheng Lu, Yung-Ho Hsu, Yuh-Feng Lin, Yuan-Hung Wang
End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. We used the Taiwan National Health Insurance Research Database to determine the incident AF among peritoneal dialysis (PD) and hemodialysis (HD) patients in Taiwan.Our ESRD cohort include Taiwan National Health Insurance Research Database, we identified 15,947 patients, who started renal replacement therapy between January 1, 2002 and December 31, 2003...
June 2016: Medicine (Baltimore)
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