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https://www.readbyqxmd.com/read/29792299/a-simple-evidence-based-approach-to-help-guide-diagnosis-of-heart-failure-with-preserved-ejection-fraction
#1
Yogesh N V Reddy, Rickey E Carter, Masaru Obokata, Margaret M Redfield, Barry A Borlaug
Background -Diagnosis of heart failure with preserved ejection fraction (HFpEF) is challenging in euvolemic patients with dyspnea, and no evidence-based criteria are available. We sought to develop and then validate non-invasive diagnostic criteria that could be used to estimate the likelihood that HFpEF is present among patients with unexplained dyspnea in order to guide further testing. Methods -Consecutive patients with unexplained dyspnea referred for invasive hemodynamic exercise testing were retrospectively evaluated...
May 23, 2018: Circulation
https://www.readbyqxmd.com/read/29792264/paradoxical-brain-embolism-shadowing-massive-pulmonary-embolism
#2
François Bagate, Alexandre Bedet, Armand Mekontso Dessap, Guillaume Carteaux
Patent foramen ovale is frequently observed in the general population. In case of massive pulmonary embolism, the sudden increase in the right heart cavity's pressure may cause a right-to-left shunting across this foramen, which could be associated with conflicting outcomes. Herein, we report a case of reversible cardiac arrest preceded by seizures, and followed by hemodynamic stability without any vasopressor. A brain CT-scan showed a limited ischemic stroke. Initial echocardiographic assessment revealed an acute cor pulmonale and a right-to-left intracardiac shunt across a large patent foramen ovale, suggesting the diagnosis of massive pulmonary embolism that was lately confirmed by a multidetector CT-angiography...
May 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29792232/effect-of-postoperative-goal-directed-therapy-in-cancer-patients-undergoing-high-risk-surgery-a-randomized-clinical-trial-and-meta-analysis
#3
Aline Rejane Muller Gerent, Juliano Pinheiro Almeida, Evgeny Fominskiy, Giovanni Landoni, Gisele Queiroz de Oliveira, Stephanie Itala Rizk, Julia Tizue Fukushima, Claudia Marques Simoes, Ulysses Ribeiro, Clarice Lee Park, Rosana Ely Nakamura, Rafael Alves Franco, Patricia Inês Cândido, Cintia Rosa Tavares, Ligia Camara, Graziela Dos Santos Rocha Ferreira, Elisangela Pinto Marinho de Almeida, Roberto Kalil Filho, Filomena Regina Barbosa Gomes Galas, Ludhmila Abrahão Hajjar
BACKGROUND: Perioperative goal-directed hemodynamic therapy (GDHT) has been advocated in high-risk patients undergoing noncardiac surgery to reduce postoperative morbidity and mortality. We hypothesized that using cardiac index (CI)-guided GDHT in the postoperative period for patients undergoing high-risk surgery for cancer treatment would reduce 30-day mortality and postoperative complications. METHODS: A randomized, parallel-group, superiority trial was performed in a tertiary oncology hospital...
May 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29791520/use-of-direct-oral-anticoagulants-for-chronic-thromboembolic-pulmonary-hypertension
#4
Francisca Alexandra Gavilanes-Oleas, Jose Leonidas Alves, Caio Julio Cesar Fernandes, Luis Felipe Lopes Prada, William Salibe Filho, Mario Terra Filho, Luciana Morinaga, Susana Hoette, Carlos Jardim, Rogerio Souza
OBJECTIVES: Chronic thromboembolic pulmonary hypertension is one of the most prevalent forms of pulmonary hypertension and is a major complication of acute pulmonary embolism. One mainstay of chronic thromboembolic pulmonary hypertension treatment is lifelong anticoagulation. The recent advent of direct oral anticoagulants for acute pulmonary embolism treatment has provided a viable and effective alternative for treating this condition. However, little is known about the efficacy of this new class of drugs for treating chronic thromboembolic pulmonary hypertension...
May 17, 2018: Clinics
https://www.readbyqxmd.com/read/29790685/f2-isoprostanes-and-f4-neuroprostanes-as-markers-of-intracranial-aneurysm-development
#5
Anna Syta-Krzyżanowska, Iwona Jarocka-Karpowicz, Jan Kochanowicz, Grzegorz Turek, Robert Rutkowski, Krzysztof Gorbacz, Zenon Mariak, Elżbieta Skrzydlewska
BACKGROUND: Intracranial aneurysms are common, occurring in about 1-2% of the population. Saccular aneurysm is a pouch-like pathological dilatation of an intracranial artery that develops when the cerebral artery wall becomes too weak to resist hemodynamic pressure and distends. OBJECTIVES: The aim of this study was to determine whether the development of intracranial aneurysms and subarachnoid hemorrhage (SAH) affects neuronal phospholipid metabolism, and what influence different invasive treatments have on brain free radical phospholipid metabolism...
April 24, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29790673/n-terminal-probrain-natriuretic-peptide-as-a-biomarker-of-moderate-to-severe-bronchopulmonary-dysplasia-in-preterm-infants-a-prospective-observational-study
#6
Silvia Rodríguez-Blanco, Ignacio Oulego-Erroz, Paula Alonso-Quintela, Sandra Terroba-Seara, Aquilina Jiménez-González, Maite Palau-Benavides
OBJECTIVE: N-terminal-probrain natriuretic peptide (NT-proBNP) is a marker of hemodynamically significant patent ductus arteriosus (HsPDA) in preterm infants. In this study, we assessed whether NT-proBNP levels could predict the risk of moderate to severe bronchopulmonary dysplasia (BPD) and/or death. METHODS: This was an observational prospective study of preterm infants with GA ≤32 weeks. Infants who died within the first 48 h or who had major congenital malformations or incomplete information were excluded...
May 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29790458/relation-of-preoperative-and-postoperative-echocardiographic-parameters-with-rejection-and-mortality-in-liver-transplant-patients
#7
Kerem Can Yilmaz, Orcun Ciftci, Arzu Neslihan Akgun, Haldun Muderrisoglu, Sedat Boyacioglu, Asuman Nihan Haberal, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Survival in liver transplant after end-stage liver disease is associated with major cardiac functions. In a significant number of patients with end-stage liver disease, cardiac dysfunctions may be observed, which can include high-output heart failure, cardiac valve disease, and pulmonary venous and arterial hypertension. All of these affect perioperative survival. The aim of our study was to determine whether preoperative and postoperative echocardiographic parameters, specifically right heart-related tricuspid regurgitation, estimated systolic pulmonary arterial pressure, and tricuspid annular plane systolic excursion, are associated with rejection and mortality in liver transplant patients...
May 23, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29790388/graft-function-assessment-in-mouse-models-of-single-and-dual-kidney-transplantation
#8
Lei Wang, Ximing Wang, Shan Jiang, Jin Wei, Jacentha Buggs, Liying Fu, Jie Zhang, Ruisheng Liu
Animal models of kidney transplantation (KTX) are widely used in studying immune response of hosts to implanted grafts. Additionally, KTX can be used in generating kidney-specific knockout animal models by transplantation of kidneys from donors with global knockout of a gene to wild type recipients or vise verse. Dual kidney transplantation (DKT) provides a more physiological environment for recipients than single kidney transplantation (SKT). However, DKT in mice is rare due to technical challenges. In this study, we successfully performed DKT in mice and compared the hemodynamic response and graft function with SKT...
May 23, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29790206/efficacy-and-safety-of-transcatheter-valve-in-valve-replacement-for-mitroflow-bioprosthetic-valve-dysfunction
#9
Victor X Mosquera, Miguel González-Barbeito, Alberto Bouzas-Mosquera, José M Herrera-Noreña, Carlos Velasco, Jorge Salgado-Fernández, Ramón Calviño-Santos, Nicolás Vázquez-González, José M Vázquez-Rodríguez, José J Cuenca-Castillo
OBJECTIVES: Bioprostheses with pericardial leaflets mounted externally on the stent pose a high risk for valve-in-valve (ViV) procedures. This study analyzed the efficacy and safety of ViV procedures for treating structural valve deterioration (SVD) in Mitroflow bioprostheses. METHODS: Between January 2012 and August 2017, 11 patients (mean age 80.3 ± 5.6 years) were treated for SVD of Mitroflow bioprostheses with transcatheter ViV procedures (six transapical [TA] and five transfemoral [TF]) using balloon expandable bioprostheses...
May 22, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#10
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29790114/ivabradine-improved-left-ventricular-function-and-pressure-overload-induced-cardiomyocyte-apoptosis-in-a-transverse-aortic-constriction-mouse-model
#11
Yihui Yu, Zuoying Hu, Bing Li, Zhimei Wang, Shaoliang Chen
This study aimed to investigate the effects and molecular mechanisms of ivabradine in preventing cardiac hypertrophy in an established transverse aortic constriction (TAC) mouse model. A total of 56 male C57BL/6 mice were randomly assigned into the following seven groups (8 mice per group): sham, TAC model, Iva-10 (10 mg/kg/day ivabradine), Iva-20 (20 mg/kg/day ivabradine), Iva-40 (40 mg/kg/day ivabradine), Iva-80 (80 mg/kg/day ivabradine), and Rap (rapamycin, a positive control). Echocardiography and left ventricular hemodynamics were performed...
May 22, 2018: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#12
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29789917/comparison-of-clinical-profiles-in-patients-with-protein-losing-enteropathy-with-and-without-fontan-circulation
#13
Shin Ono, Hideo Ohuchi, Aya Miyazaki, Osamu Yamada
Protein-losing enteropathy (PLE) is a life-threatening complication in patients following the Fontan operation. However, PLE also develops in some patients with congenital heart disease (CHD) after biventricular repair (BVR). This study compared clinical profiles of PLE patients following the Fontan operation with those after BVR. We retrospectively reviewed clinical charts of postoperative CHD patients with PLE. The study population comprised 42 PLE patients (14BVR, 28Fontan). Postoperative follow-up period until onset was significantly shorter in the Fontan group than in the BVR group (14 ± 2 vs...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789877/-meta-analyses-on-measurement-precision-of-non-invasive-hemodynamic-monitoring-technologies-in-adults
#14
G Pestel, K Fukui, M Higashi, I Schmidtmann, C Werner
An ideal non-invasive monitoring system should provide accurate and reproducible measurements of clinically relevant variables that enables clinicians to guide therapy accordingly. The monitor should be rapid, easy to use, readily available at the bedside, operator-independent, cost-effective and should have a minimal risk and side effect profile for patients. An example is the introduction of pulse oximetry, which has become established for non-invasive monitoring of oxygenation worldwide. A corresponding non-invasive monitoring of hemodynamics and perfusion could optimize the anesthesiological treatment to the needs in individual cases...
May 22, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29789692/pulse-pressure-amplification-and-cardiac-autonomic-dysfunction-in-patients-with-type-2-diabetes-mellitus
#15
Ioanna Eleftheriadou, George C Drosos, Anastasios Tentolouris, Konstantonis George, Petros P Sfikakis, Athanasios D Protogerou, Nikolaos Tentolouris
The main aim of this cross-sectional study was to investigate the association between pulse pressure amplification (PPA) and cardiac autonomic activity (baroreflex sensitivity (BRS) and heart rate variability (HRV)) in patients with type 2 diabetes mellitus (T2DM). In addition, we examined the association between cardiac autonomic activity and central hemodynamic parameters that may affect PPA such as augmentation index (AIx), aortic stiffness (pulse wave velocity (PWV)), and common carotid artery stiffness distensibility coefficient (DC)...
May 23, 2018: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29789605/neuromodulation-of-sensory-networks-in-monkey-brain-by-focused-ultrasound-with-mri-guidance-and-detection
#16
Pai-Feng Yang, M Anthony Phipps, Allen T Newton, Vandiver Chaplin, John C Gore, Charles F Caskey, Li Min Chen
Focused ultrasound (FUS) has gained recognition as a technique for non-invasive neuromodulation with high spatial precision and the ability to both excite and inhibit neural activity. Here we demonstrate that MRI-guided FUS is capable of exciting precise targets within areas 3a/3b in the monkey brain, causing downstream activations in off-target somatosensory and associated brain regions which are simultaneously detected by functional MRI. The similarity between natural tactile stimulation-and FUS- evoked fMRI activation patterns suggests that FUS likely can excite populations of neurons and produce associated spiking activities that may be subsequently transmitted to other functionally related touch regions...
May 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29789413/best-protocol-for-the-sit-to-stand-test-in-subjects-with-copd
#17
Andrea A Morita, Gianna W Bisca, Felipe V C Machado, Nidia A Hernandes, Fabio Pitta, Vanessa S Probst
BACKGROUND: Different protocols for the sit-to-stand test (STS) are available for assessing functional capacity in COPD. We sought to correlate each protocol of the STS (ie, the 5-repetition [5-rep STS], the 30-s STS, and the 1-min STS) with clinical outcomes in subjects with COPD. We also aimed to compare the 3 protocols of the STS, to verify their association and agreement, and to verify whether the 3 protocols are able to predict functional exercise capacity and physical activity in daily life (PADL)...
May 22, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29789202/relationship-between-prolonged-neural-suppression-and-cerebral-hemodynamic-dysfunction-during-hypothermia-in-asphyxiated-piglets
#18
Wataru Jinnai, Shinji Nakamura, Kosuke Koyano, Satoshi Yamato, Takayuki Wakabayashi, Yinmon Htun, Yasuhiro Nakao, Takashi Iwase, Makoto Nakamura, Saneyuki Yasuda, Masaki Ueno, Takanori Miki, Takashi Kusaka
OBJECTIVES: Hypothermia (HT) improves the outcome of neonatal hypoxic-ischemic encephalopathy. Here, we investigated changes during HT in cortical electrical activity using amplitude-integrated electroencephalography (aEEG) and in cerebral blood volume (CBV) and cerebral hemoglobin oxygen saturation using near-infrared time-resolved spectroscopy (TRS) and compared the results with those obtained during normothermia (NT) after a hypoxic-ischemic (HI) insult in a piglet model of asphyxia...
May 19, 2018: Brain & Development
https://www.readbyqxmd.com/read/29788983/role-of-pulmonary-hemodynamics-in-determining-6-minute-walk-test-result-in-atrial-septal-defect-an-observational-study
#19
Supomo Supomo, Handy Darmawan, Adika Zhulhi Arjana
BACKGROUND: The presence of altered pulmonary hemodynamics in adult patients with atrial septal defect (ASD) is common. However, there are no observational studies which evaluate the impact of altered pulmonary hemodynamics on the 6-min walk test (6MWT) result. This study aimed to investigate the role of pulmonary hemodynamics in determining 6MWT result of patients with ASD. METHOD: Forty-six consecutive adult patients with ASD were included in this study. Right heart catheterization was performed to obtain the pulmonary hemodynamics profile...
May 22, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29788919/prediction-of-fluid-responsiveness-in-mechanically-ventilated-cardiac-surgical-patients-the-performance-of-seven-different-functional-hemodynamic-parameters
#20
Michael T Ganter, Martin Geisen, Sonja Hartnack, Omer Dzemali, Christoph K Hofer
BACKGROUND: Functional hemodynamic parameters such as stroke volume and pulse pressure variation (SVV and PPV) have been shown to be reliable predictors of fluid responsiveness in mechanically ventilated patients. Today, different minimally- and non-invasive hemodynamic monitoring systems measure functional hemodynamic parameters. Although some of these parameters are described by the same name, they differ in their measurement technique and thus may provide different results. We aimed to test the performance of seven functional hemodynamic parameters simultaneously in the same clinical setting...
May 22, 2018: BMC Anesthesiology
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