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https://www.readbyqxmd.com/read/28153356/mechanical-circulatory-support-for-end-stage-heart-failure
#1
Alain Combes
Mechanical circulatory assistance has become a frequent therapeutic option for patients with advanced heart failure. For patients with acute cardiogenic shock and impaired organ function, short-term assistance with venoarterial extracorporeal membrane oxygenation is the leading therapeutic option. It enables a "bridge to decision-making" i.e. withdrawal of the device after myocardial recovery or after recognition of therapeutic futility, or as a bridge-to-transplantation or to long-term mechanical support. For Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 2-6 patients, implantation of a long-term ventricular assist-device (VAD) should be considered before progression to multiple organ failure if heart transplantation is not a first-line option...
January 11, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28096838/a-rare-case-of-myocardial-bridge-involving-left-anterior-descending-obtuse-marginal-and-ramus-intermediate-coronary-arteries
#2
Tuncay Kiris, Diyar Koprulu, Muzaffer Elmali, Gonul Zeren, Guney Erdogan
Myocardial bridging, a congenital coronary anomaly, is a cluster of myocardial fibers crossing over the epicardial coronary arteries. It is most frequently seen in the left anterior descending artery (LAD), and rarely involves the circumflex (CX) and right coronary artery (RCA). We report a patient with an unusual coronary bridge crossing over the left anterior descending, obtuse marginal and ramus intermediate branches. The patient presented with exercise-induced angina pectoris that was relieved with medical therapy...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28095452/influence-of-mechanical-circulatory-support-on-endothelin-receptor-expression-in-human-left-ventricular-myocardium-from-patients-with-dilated-cardiomyopathy-dcm
#3
Florian Gärtner, Getu Abraham, Astrid Kassner, Daniela Baurichter, Hendrik Milting
BACKGROUND: In terminal failing hearts ventricular assist devices (VAD) are implanted as a bridge to transplantation. Endothelin receptor (ETR) antagonists are used for treatment of secondary pulmonary hypertension in VAD patients. However, the cardiac ETR regulation in human heart failure and during VAD support is incompletely understood. METHODS: In paired left ventricular samples of 12 dilated cardiomyopathy patients we investigated the density of endothelin A (ETA) and B (ETB) receptors before VAD implantation and after device removal...
2017: PloS One
https://www.readbyqxmd.com/read/28087265/myocardial-relaxation-is-accelerated-by-fast-stretch-not-reduced-afterload
#4
Charles S Chung, Charles W Hoopes, Kenneth S Campbell
Fast relaxation of cross-bridge generated force in the myocardium facilitates efficient diastolic function. Recently published research studying mechanisms that modulate the relaxation rate has focused on molecular factors. Mechanical factors have received less attention since the 1980s when seminal work established the theory that reducing afterload accelerates the relaxation rate. Clinical trials using afterload reducing drugs, partially based on this theory, have thus far failed to improve outcomes for patients with diastolic dysfunction...
January 11, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28073988/posteromedial-papillary-muscle-rupture-due-to-squeezing-of-the-left-anterior-descending-coronary-artery
#5
Kaoru Hattori, Kozo Fukui, Nobuaki Suzuki, Kazuo Ito
An unusual case of posteromedial papillary muscle (PPM) rupture due to isolated left anterior descending (LAD) artery ischaemia, associated with severe myocardial bridge contraction, is presented. The unusual blood supply to the PPM was associated with its apical origin and apex-forming LAD.
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28065231/impact-of-myocardial-bridge-mural-coronary-artery-on-myocardial-blood-supply
#6
Xin-Bin Zhao, Yu Fu, Xiao-Bo Dong, Zhi Qi
Objective To explore the impact of myocardial bridge-mural coronary artery (MB-MCA) on myocardial blood supply. Methods The imaging data of 74 patients with the isolate MB in the left anterior descending artery undergoing 256-slice CT coronary angiography and myocardial perfusion imaging (MPI) were retrospectively analyzed. The subjects were divided into incomplete and complete MB types. The length of MB and the systolic stenosis degree of MCA were measured.The type and length of MB and the systolic stenosis degree of MCA (according to Noble grade) were compared between the normal and abnormal MPI groups...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28040759/novel-application-of-a-percutaneous-left-ventricular-assist-device-as-a-bridge-to-transplant-in-a-paediatric-patient-with-severe-heart-failure-due-to-viral-myocarditis
#7
Paul Perry, Elizabeth David, Broadus Atkins, Gary Raff
A 13-year obese female with suspected viral myocarditis presented with acute decompensated heart failure. Due to her body habitus, she was a poor candidate for immediate heart transplantation. A peripherally inserted left ventricular assist device (LVAD) was implanted via the right axillary artery. Following device insertion the patient experienced rapid improvement in symptoms. The LVAD provided effective left ventricular unloading for 50 days, promoting myocardial recovery and maintaining excellent patient performance status...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28039126/are-olympic-athletes-free-from-cardiovascular-diseases-systematic-investigation-in-2352-participants-from-athens-2004-to-sochi-2014
#8
Antonio Pelliccia, Paolo Emilio Adami, Filippo Quattrini, Maria Rosaria Squeo, Stefano Caselli, Luisa Verdile, Viviana Maestrini, Fernando Di Paolo, Cataldo Pisicchio, Roberto Ciardo, Antonio Spataro
CONTEXT: Olympic athletes represent model of success in our society, by enduring strenuous conditioning programmes and achieving astonishing performances. They also raise scientific and clinical interest, with regard to medical care and prevalence of cardiovascular (CV) abnormalities. OBJECTIVE: Our aim was to assess the prevalence and type of CV abnormalities in this selected athlete's cohort. DESIGN, SETTING AND PARTICIPANTS: 2352 Olympic athletes, mean age 25±6, 64% men, competing in 31 summer or 15 winter sports, were examined with history, physical examination, 12-lead and exercise ECG and echocardiography...
February 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28031643/dynamic-systolic-compression-of-the-left-anterior-descending-coronary-artery-by-a-postinfarction-dyskinetic-left-ventricular-aneurysm
#9
Pinar Dogan, Fatih Oksuz, Enis Grbovic, Ozcan Ozeke, Omac Tufekcioglu
Dynamic systolic compression of the coronary arteries is almost always due to the existence of myocardial bridging that is most commonly localized in the middle segment of the left anterior descending coronary artery. However, it has rarely been reported in patients with pericardial adhesions, tumor, foreign body, or pseudoaneurysms. Only rare case reports exist regarding dynamic coronary compression by a dyskinetic left ventricular aneurysm. We present a patient with a myocardial bridge-like systolic compression of the distal left anterior descending caused by postinfarction dyskinetic left ventricular aneurysm...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28007148/left-anterior-descending-artery-myocardial-bridging-a-clinical-approach
#10
REVIEW
Giuseppe Tarantini, Federico Migliore, Filippo Cademartiri, Chiara Fraccaro, Sabino Iliceto
A myocardial bridge (MB) is the term for the muscle overlying the intramyocardial segment of the epicardial coronary artery (referred to as a tunneled artery). Although MBs can be found in any epicardial artery, most of them involve the left anterior descending artery. These congenital coronary anomalies have long been recognized anatomically, and are traditionally considered a benign condition; however, the association between myocardial ischemia and MBs has increased their clinical relevance. This review summarizes the prevalence, pathophysiology, and diagnostic findings, including morphological, functional assessment, and treatment of patients with MB involving the left anterior descending artery, suggesting a pragmatic clinical approach to this entity...
December 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969972/tct-600-impact-of-myocardial-bridging-on-atherosclerotic-plaque-vulnerability-assessed-by-oct
#11
Ryotaro Yamada, Teruyoshi Kume, Yutaka Goryo, Terumasa Koyama, Kenzo Fukuhara, Yasuhiko Kamata, Yusuke Kobayashi, Hiroshi Okamoto, Yoji Neishi, Shiro Uemura
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27937122/rational-screening-of-peroxisome-proliferator-activated-receptor-%C3%AE-agonists-from-natural-products-potential-therapeutics-for-heart-failure
#12
Rui Chen, Jing Wan, Jing Song, Yan Qian, Yong Liu, Shuiming Gu
CONTEXT: Peroxisome proliferator-activated receptor-γ (PPARγ) is a member of the nuclear hormone receptor superfamily of ligand-activated transcription factors. Activation of PPARγ pathway has been shown to enhance fatty acid oxidation, improve endothelial cell function, and decrease myocardial fibrosis in heart failure. Thus, the protein has been raised as an attractive target for heart failure therapy. OBJECTIVE: This work attempted to discover new and potent PPARγ agonists from natural products using a synthetic strategy of computer virtual screening and transactivation reporter assay...
December 2017: Pharmaceutical Biology
https://www.readbyqxmd.com/read/27928223/impact-of-old-age-on-clinical-and-angiographic-characteristics-of-coronary-artery-spasm-as-assessed-by-acetylcholine-provocation-test
#13
Woong Gil Choi, Soo Hyun Kim, Seung-Woon Rha, Kang-Yin Chen, Yong-Jian Li, Byoung Geol Choi, Se Yeon Choi, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
BACKGROUND: Smoking and other risk factors have been well known as important factors of variant angina or coronary artery spasm (CAS). However, clinical features related to age on coronary artery spasm have been rarely evaluated. METHODS: We evaluated 3155 consecutive patients with insignificant coronary artery lesion. Patients underwent Acetylcholine (Ach) provocation test for induction of CAS. CAS was defined as > 70% luminal narrowing of coronary arteries during Ach provocation test...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27911047/modified-mrna-as-a-therapeutic-tool-to-induce-cardiac-regeneration-in-ischemic-heart-disease
#14
REVIEW
Yoav Hadas, Michael G Katz, Charles R Bridges, Lior Zangi
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality in developed countries. Current pharmacological and interventional therapies provide significant improvement in the life quality of patient; however, they are mostly symptom-oriented and not curative. A high disease and economic burden of IHD requires the search for new therapeutic strategies to significantly improve patients' prognosis and quality of life. One of the main challenges during IHD is the massive loss of cardiomyocytes that possess minimal regenerative capacity...
January 2017: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/27910057/molecular-cardiac-surgery-with-recirculating-delivery-mcard-procedure-and-vector-transfer
#15
Michael G Katz, Anthony S Fargnoli, Andrew P Kendle, Charles R Bridges
Despite progress in clinical treatment, cardiovascular diseases are still the leading cause of morbidity and mortality worldwide. Therefore, novel therapeutic approaches are needed, targeting the underlying molecular mechanisms of disease with improved outcomes for patients. Gene therapy is one of the most promising fields for the development of new treatments for the advanced stages of cardiovascular diseases. The establishment of clinically relevant methods of gene transfer remains one of the principal limitations on the effectiveness of gene therapy...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27910052/a-needleless-liquid-jet-injection-delivery-approach-for-cardiac-gene-therapy
#16
Anthony S Fargnoli, Michael G Katz, Charles R Bridges
Fundamentally, cardiac gene therapy clinical trials have demonstrated that route efficiency is paramount in achieving maximum myocardial expression within safety limits. Gene transfer phenomena are largely influenced by physical transport principles (i.e., pressure, residence time, dispersion trafficking, mechanical resistance) that are independent of therapeutic characteristics. An alternative to intracoronary infusion methods, in an effort to improve efficiency in terms of cardiac specificity, is direct myocardial delivery via surgical injection...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27909469/value-of-the-wearable-cardioverter-defibrillator-wcd-as-a-bridging-therapy-before-implantation-of-a-cardioverter-defibrillator-icd
#17
REVIEW
Priv- Doz, Dr Johannes Sperzel
Wearable cardioverter defibrillators (WCD), initially available in 2002, have recently experienced more routine use in many institutions as a means of preventing sudden cardiac death (SCD) prior to implantable cardioverter defibrillator (ICD) evaluation or implantation. WCD differ from ICD by their noninvasive nature, making them well suited for patient populations who have a chance for significant cardiac recovery (such as after an acute myocardial infarction). Despite their noninvasive nature, WCD treatment of sustained ventricular tachyarrhythmias is highly successful...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909224/sarcomeric-protein-modification-during-adrenergic-stress-enhances-cross-bridge-kinetics-and-cardiac-output
#18
Kenneth S Gresham, Ranganath Mamidi, Jiayang Li, Hyerin Kwak, Julian E Stelzer
Molecular adaptations to chronic neurohormonal stress, including sarcomeric protein cleavage and phosphorylation, provide a mechanism to increase ventricular contractility and enhance cardiac output, yet the link between sarcomeric protein modifications and changes in myocardial function remains unclear. To examine the effects of neurohormonal stress on post-translational modifications of sarcomeric proteins, mice were administered combined α- and β-adrenergic receptor agonists (isoproterenol and phenylephrine; IPE) for 14 days using implantable osmotic pumps...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27907931/coronary-artery-anomalies-diagnosis-and-classification-based-on-cardiac-ct-and-mri-cmr-from-alcapa-to-anomalies-of-termination
#19
Philipp Heermann, Walter Heindel, Christoph Schülke
Background Coronary artery anomalies encompass a clinically and anatomically variable spectrum including physiological variants and pathophysiologically relevant anomalies. The majority of the variants has no hemodynamic relevance and is often detected accidentally. The recognition of the rare and relevant anomalies that cause either relevant shunt volumes leading to myocardial ischemia or ventricular tachyarrhythmias with the risk of sudden cardiac death is of major importance. Methods This review is based on a literature search in PubMed conducted using the key words "coronary artery" and/or "anomaly" and/or "anomalous origin" and/or "myocardial bridging" and/or "coronary artery fistula" and/or "Bland-White-Garland" and/or "ALCAPA"...
January 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27903374/-the-relationship-between-myocardial-bridge-in-mural-coronary-artery-segment-and-coronary-atherosclerosis
#20
S J Ding, R C Huang, C F Jia, L Zhong, P An, Z Q Wang, H Zhu, B L Wu, X C Zhou
Objective: The myocardial bridging (MB) prevalence, anatomic characteristics of MB, and the relationship between characteristics of MB in mural coronary artery segment and coronary atherosclerosis were analyzed. Methods: In this perspective nonrandomized controlled study, a total of 1 132 patients who admitted to our hospital for suspected or known coronary artery disease from January 2012 to June 2013 were enrolled. All patients underwent dual-source 64-slice spiral CT coronary angiography. The general patient characteristics including gender, age, history of hypertension, diabetes, hyperlipidemia and smoking, serum level of total cholesterol (TC) and LDL-C were recorded...
October 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
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