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Ya-Se Zhuang, Ying-Ying Liao, Bo-Yi Liu, Zhi-Cheng Fang, Li Chen, Li Min, Wei Chen
OBJECTIVE: To clarify the influence of MicroRNA-27a (miR-27a)-mediated Wnt/β-catenin pathway on the myocardial fibrosis in rats with chronic heart failure (CHF). METHODS: The CHF rat models were constructed and randomly divided into four groups (Sham, Model, AntagomiR-27a, and NC antagomiR-27a groups). Echocardiography was used to test the cardiac function indexes, HE (haematoxylin-eosin) staining to observe the pathological injury of myocardium, Masson staining to analyze the collagen volume fraction (CVF), and qRT-PCR (quantitative real-time PCR) and Western blotting to detect the expressions of miR-27a and Wnt/β-catenin pathway-related proteins...
September 20, 2018: Cardiovascular Therapeutics
Chetna Malhotra, David Sim, Fazlur Jaufeerally, Eric A Finkelstein
OBJECTIVES: To make informed choices about use of future invasive life-sustaining interventions (ILSI), patients with congestive heart failure (CHF) need to correctly understand the intent of their current treatments. However, healthcare providers may be wary of having these discussions due to fear of distressing patients. In this study, we assessed whether patients who understand their treatment intent are less willing to undergo ILSI and are indeed more psychologically distressed. DESIGN, PARTICIPANTS AND OUTCOMES: As part of a cross-sectional survey conducted prior to randomising patients for a trial, we asked 282 patients with advanced CHF (New York Heart Association Class III and IV) whether they believe their existing treatments would cure their heart condition, their willingness to undergo ILSI and assessed their anxiety and depression using the Hospital Anxiety and Depression Scale...
September 19, 2018: BMJ Open
Ahmed Subahi, Abdullah Abdullah, Ahmed S Yassin, Hossam Abubakar, Ashraf Abugroun, George Eigbire, Amr Salama, Abdul Wahab, Ayman Abulawi, Eyas Kanaan, Aamer Javed, Mahir Elder, Amir Kaki, Richard Alweis, Tamam Mohamad
INTRODUCTION: Congestive heart failure (CHF) is seen in up to 13-25% of patients with NSTEMI. Recent data describing the impact of congestive heart failure (CHF) on in-hospital outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) in the United States is limited. We sought to examine the in-hospital outcomes, and management of CHF in patients admitted to the hospital with NSTEMI. METHODS: National Inpatient Sample (NIS) database (2010-2014) was analyzed to identify patients with NSTEMI using ICD-9-CM codes...
September 13, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Deborah L Enns, Margaret T Mandelson, David M Aboulafia
Objective: To determine the utility of routine measurements of left ventricular ejection fraction (LVEF) before the administration of doxorubicin-based chemotherapy (DOX) in patients with diffuse large B-cell lymphoma (DLBCL). Patients and Methods: We investigated the frequency of LVEF measurements before the initiation of therapy in 291 patients with DLBCL at our institution from January 1, 2001, through December 31, 2013, and reviewed whether LVEF varied in patients with an underlying risk of cardiac disease (CD), the relationship between LVEF and subsequent DLBCL treatment, and congestive heart failure (CHF) occurrence in DOX-treated patients...
September 2018: Mayo Clinic proceedings. Innovations, quality & outcomes
Chetna Malhotra, Renette Foo, Ratna Singh, Semra Ozdemir, Irene Teo, David Sim, Fazlur Jaufeerally, Than Aung, Yeo Khung Keong, Nivedita Nadkarni, Eric Andrew Finkelstein
INTRODUCTIO: Understanding the symptom and health expenditure burden among patients with advanced congestive heart failure (CHF) and their family caregivers is essential to reform policy and practice needed to provide quality care to these patients at affordable prices. The proposed cohort study titled Singapore Cohort of Patients with Advanced Heart Failure aims to describe trajectories of quality of life among patients and their primary informal caregivers, quantify healthcare utilisation and expenditures, assess changes in patient and caregiver awareness of and preferences for knowing diagnostic and prognostic information, awareness and utilisation of palliative care services, preferences for treatments and decision making, perceived quality of care, self-care, caregiver psychological distress and caregiver burden...
September 17, 2018: BMJ Open
Lukasz Filip Grochola, Christopher Soll, Adrian Zehnder, Roland Wyss, Pascal Herzog, Stefan Breitenstein
BACKGROUND: Although single-port laparoscopic cholecystectomy (SILC) is safe and effective, inherent surgeons' discomfort has prevented a large-scale adaptation of this technique. Recent advances in robotic technology suggest that da Vinci Single-Site™ cholecystectomy (dVSSC) may overcome this issue by reducing the stress load of the surgeon compared to SILC. However, evidence to objectively assess differences between the two approaches is lacking. METHODS: 60 patients [36 women, 24 men (mean age 52 years)] with benign gallbladder disease were randomly assigned to dVSSC (n = 30) or SILC (n = 30) in this single-centre, single-blinded controlled trial...
September 14, 2018: Surgical Endoscopy
Kyle D Buchanan, Paul Kolm, Micaela Iantorno, Deepakraj Gajanana, Toby Rogers, Jiaxiang Gai, Rebecca Torguson, Itsik Ben-Dor, William O Suddath, Lowell F Satler, Ron Waksman
BACKGROUND/PURPOSE: Appropriate patient selection for mechanical circulatory support following percutaneous coronary intervention (PCI) remains a challenge. This study aims to evaluate the role of coronary perfusion pressure and other left ventricular hemodynamics to predict cardiovascular collapse following PCI. METHODS/MATERIALS: We retrospectively analyzed all patients who underwent PCI for acute coronary syndrome (ACS) from 2003 to 2016. Coronary perfusion pressure was calculated for each patient and defined as the difference in mean arterial pressure and left ventricular end diastolic pressure (LVEDP)...
September 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Jessica L Ward, Gregory R Lisciandro, Wendy A Ware, Austin K Viall, Brent D Aona, Kari A Kurtz, Yamir Reina-Doreste, Teresa C DeFrancesco
BACKGROUND: The diagnosis of congestive heart failure (CHF) in cats is challenging. Point-of-care (POC) thoracic ultrasound and NT-proBNP testing are emerging tools that may aid in diagnosis. HYPOTHESIS/OBJECTIVES: To assess the diagnostic accuracy of POC lung ultrasound (LUS), focused cardiac ultrasound (FCU), and NT-proBNP in predicting a final diagnosis of CHF. ANIMALS: Fifty-one cats in respiratory distress. METHODS: Blood NT-proBNP, LUS, and FCU evaluating left atrial (LA) size and presence of pericardial effusion (PCEFF) were performed in all cats...
September 14, 2018: Journal of Veterinary Internal Medicine
Tommaso Vezzosi, Oriol Domenech, Giulia Costa, Federica Marchesotti, Luigi Venco, Eric Zini, Maria Josefa Fernández Del Palacio, Rosalba Tognetti
BACKGROUND: Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH). HYPOTHESIS/OBJECTIVES: To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right-sided congestive heart failure (R-CHF). ANIMALS: 89 dogs with PH and 74 healthy dogs. METHODS: Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient...
September 14, 2018: Journal of Veterinary Internal Medicine
Melanie J Hezzell, Chloë L Block, Danielle S Laughlin, Mark A Oyama
BACKGROUND: Treatment targeted to achieve reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) improves outcomes in human congestive heart failure (CHF) patients. HYPOTHESIS: A pre-specified therapeutic algorithm that increased diuretic or pimobendan usage will reduce plasma NT-proBNP concentrations in dogs with CHF secondary to myxomatous mitral valve disease (MMVD). ANIMALS: Twenty-six dogs with clinically stable CHF secondary to MMVD...
September 14, 2018: Journal of Veterinary Internal Medicine
Matthew K H Tan, Joanna K L Wong, Kishan Bakrania, Yusuf Abdullahi, Leanne Harling, Roberto Casula, Alex V Rowlands, Thanos Athanasiou, Omar A Jarral
Background: Actigraphy is increasingly incorporated into clinical practice to monitor intervention effectiveness and patient health in congestive heart failure (CHF). We explored the prognostic impact of actigraphy-quantified physical activity (AQPA) on CHF outcomes. Methods: PubMed and Medline databases were systematically searched for cross-sectional studies, cohort studies or randomised controlled trials from January 2007 to December 2017. We included studies that used validated actigraphs to predict outcomes in adult HF patients...
September 12, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Donald E Fry, Susan M Nedza, Michael Pine, Agnes M Reband, Chun-Jung Huang, Gregory Pine
It is important that actual outcomes of care and not surrogate markers, such as process measures, be used to evaluate the quality of inpatient care. Because of the heterogenous composition of patients, risk-adjustment is essential for the objective evaluation of outcomes following inpatient care. Comparative evaluation of risk-adjusted outcomes can be used to identify suboptimal performance and can provide direction for care improvement initiatives.We studied the risk-adjusted outcomes of 6 medical conditions during the inpatient and 90-day post-discharge period to identify the opportunities for care improvement...
September 2018: Medicine (Baltimore)
Ya-Han Hu, Chun-Tien Tai, Chih-Fong Tsai, Min-Wei Huang
Digoxin is a high-alert medication because of its narrow therapeutic range and high drug-to-drug interactions (DDIs). Approximately 50% of digoxin toxicity cases are preventable, which motivated us to improve the treatment outcomes of digoxin. The objective of this study is to apply machine learning techniques to predict the appropriateness of initial digoxin dosage. A total of 307 inpatients who had their conditions treated with digoxin between 2004 and 2013 at a medical center in Taiwan were collected in the study...
2018: Journal of Healthcare Engineering
Justien Cornelis, Jonathan Myers, Hein Heidbuchel, Christiaan Vrints, Paul Beckers
Persistent AF is present in at least 20 % of patients with chronic heart failure (CHF) and is related to a poor prognosis and more severe cardiac arrhythmias. CHF and AF share a common pathophysiology and can exacerbate one another. Exercise programmes for people with CHF have been shown to improve aerobic capacity, prognosis and quality of life. Given that patients with both CHF and AF show greater impairment in exercise performance, exercise training programmes have the potential to be highly beneficial. Optimal clinical evaluation using a cardiopulmonary exercise test should be performed before starting a training programme...
August 2018: Cardiac failure review
Bianca Beghé, Leonardo M Fabbri, Martina Garofalo, Michela Schito, Alessia Verduri, Monica Bortolotti, Mariarita Stendardo, Valentina Ruggieri, Alessandro Fucili, Nicola Sverzellati, Giovanni Della Casa, Elisa Maietti, Enrico M Clini, Piera Boschetto
BACKGROUND: In elderly smokers, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) usually present with dyspnoea. COPD and CHF are associated -almost invariably with concomitant chronic diseases, which contribute to severity and prognosis. OBJECTIVES: We investigated similarities and differences in the clinical presentation, concomitant chronic diseases and risk factors for -mortality and hospitalization at 3-year follow-up in elderly smokers/ex-smokers with a primary diagnosis of COPD or CHF recruited and followed in specialized centers...
September 11, 2018: Respiration; International Review of Thoracic Diseases
Steven S Coughlin, Lufei Young
Many Veterans Affairs (VA) patients with the complications of cardiometabolic syndrome (CMS) use both VA and community providers and facilities outside of VA. Although dual health care systems increase care options, dual use also increases coordination needs. The fragmentation and duplication of health care due to the use of multiple facilities and providers may hinder effective care coordination, result in less efficient and more costly care, and lead to poorer outcomes. This article, which is based upon bibliographic searches in PubMed, reviews the evidence on dual use of VA and community health care by Veterans for acute myocardial infarction (AMI), congestive heart failure (CHF), and diabetes mellitus, the most common CMS complications requiring acute care and post-acute care services...
August 2018: Journal of hospital management and health policy
Xiang Nie, Jiahui Fan, Huaping Li, Zhongwei Yin, Yanru Zhao, Beibei Dai, Nianguo Dong, Chen Chen, Dao Wen Wang
Previously, we found that the miR-217 expression level was increased in hearts from chronic heart failure (CHF) patients by using miRNA profile analysis. This study aimed to explore the role of miR-217 in cardiac dysfunction. Heart tissue samples from CHF patients were used to detect miR-217 expression levels. A type 9 recombinant adeno-associated virus (rAAV9) was employed to manipulate miR-217 expression in mice with thoracic aortic constriction (TAC)-induced cardiac dysfunction. Cardiac structure and function were measured by echocardiography and invasive pressure-volume analysis...
September 7, 2018: Molecular Therapy. Nucleic Acids
Michael Apostol, Matthew Keeran, Nicholas Klempf, Victoria McCoskey, Amy A Ernst, Steven J Weiss, Dusadee Sarangarm
BACKGROUND: Previous studies of thyroid stimulating hormone (TSH) levels in Emergency Department (ED) patients largely have centered on patients with atrial fibrillation (AF). In our ED patients with AF as well as patients with Psychiatric diagnoses (psych) are screened. The purpose of the present study was to compare TSH levels in the 2 groups. Our hypotheses were that an abnormal TSH and/or AF predicted the need for hospital admission and that TSH is more likely decreased in AF and increased in psych patients...
August 30, 2018: American Journal of Emergency Medicine
Julio Núñez, Raquel Heredia, Ana Payá, Ignacio Sanchis, Susana Del Prado, Gema Miñana, Enrique Santas, Rafael de la Espriella, Eduardo Núñez, Juan Sanchis, Antoni Bayés-Genís
AIMS: Optimal diuretic treatment of patients with refractory congestive heart failure (CHF) remains to be elucidated. In this work, we aimed to evaluate the serial changes of functional class and surrogates of fluid overload (weight and antigen carbohydrate 125) after addition of oral acetazolamide in patients with refractory CHF. Likewise, serial changes in renal function, serum electrolytes and pH were evaluated. METHOD: This is an observational retrospective study in which 25 ambulatory patients with refractory CHF that received acetazolamide in addition to standard intensive diuretic strategy were evaluated...
September 6, 2018: Cardiovascular Therapeutics
Li Wang, Kai Gao, Dan Wang
Objectives: Exercise training is a well-known accelerator for the treatment of chronic heart failure (CHF). The current study aimed to investigate the restorative effects of aerobic interval training (AIT) intervention on myocardial energy metabolism in CHF rats. Materials and Methods: Post-myocardial infarction (MI) heart failure animal model was established. The Sprague-Dawley rats were randomly divided into sham operation group (Sham group), CHF model group, and CHF exercise group (Exercise-CHF group)...
August 2018: Iranian Journal of Basic Medical Sciences
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