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https://www.readbyqxmd.com/read/29142012/a-transcatheter-interatrial-shunt-device-for-the-treatment-of-heart-failure-with-preserved-ejection-fraction-reduce-lap-hf-i-a-phase-2-randomized-sham-controlled-trial
#1
Ted Feldman, Laura Mauri, Rami Kahwash, Sheldon Litwin, Mark J Ricciardi, Pim van der Harst, Martin Penicka, Peter S Fail, David M Kaye, Mark C Petrie, Anupam Basuray, Scott L Hummel, Rhondalyn Forde-McLean, Christopher D Nielsen, Scott Lilly, Joseph M Massaro, Daniel Burkhoff, Sanjiv J Shah
Background -In non-randomized, open-label studies, a transcatheter interatrial shunt device (IASD, Corvia Medical) was associated with lower pulmonary capillary wedge pressure (PCWP), less symptoms, and greater quality of life and exercise capacity in patients with heart failure (HF) and mid-range or preserved ejection fraction (EF ≥ 40%). We conducted the first randomized, sham-controlled trial to evaluate the IASD in HF with EF ≥ 40%. Methods -REDUCE LAP-HF I was a phase 2, randomized, parallel-group, blinded multicenter trial in patients with New York Heart Association (NYHA) class III or ambulatory class IV HF, EF ≥ 40%, exercise PCWP ≥ 25 mmHg, and PCWP-right atrial pressure gradient ≥ 5 mmHg...
November 15, 2017: Circulation
https://www.readbyqxmd.com/read/29032225/right-ventricular-dysfunction-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-a-hemodynamic-analysis-of-the-should-we-emergently-revascularize-occluded-coronaries-for-cardiogenic-shock-shock-trial-and-registry
#2
Anuradha Lala, Yu Guo, Jinfeng Xu, Michele Esposito, Kevin Morine, Richard Karas, Stuart D Katz, Judith S Hochman, Daniel Burkhoff, Navin K Kapur
BACKGROUND: The prevalence and significance of right ventricular dysfunction (RVD) in patients with cardiogenic shock due to acute myocardial infarction (AMI-CS) has not been well characterized. We hypothesized that RVD is common in AMI-CS and associated with worse clinical outcomes. METHODS AND RESULTS: We retrospectively analyzed patients with available hemodynamics enrolled in the SHould we emergently revascularize Occluded coronaries for Cardiogenic shocK (SHOCK) Trial (n=139) and Registry (n=258) to identify RVD in AMI-CS...
October 11, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29031870/novel-parameter-to-predict-left-ventricular-filling-pressure-product-of-lnbnp-and-e-a-ratio
#3
Masayoshi Oikawa, Atsushi Kobayashi, Kento Wada, Takamasa Sato, Satoshi Suzuki, Akiomi Yoshihisa, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Takafumi Ishida, Yasuchika Takeishi
BACKGROUND: Several echocardiographic parameters are currently being employed to evaluate left ventricular (LV) filling pressure. However, these parameters are not always consistent in the clinical setting. We aimed to determine a novel parameter by multiplying log B-type natriuretic peptide (lnBNP) and mitral inflow early and late diastolic filling velocity ratio (E/A) for the prediction of pulmonary capillary wedge pressure (PCWP). METHODS AND RESULTS: One hundred and ninety-eight patients suspected of chronic heart failure were analyzed...
October 12, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29020341/percutaneous-short-term-active-mechanical-support-devices-in-cardiogenic-shock-a-systematic-review-and-collaborative-meta-analysis-of-randomized-trials
#4
Holger Thiele, Alexander Jobs, Dagmar M Ouweneel, Jose P S Henriques, Melchior Seyfarth, Steffen Desch, Ingo Eitel, Janine Pöss, Georg Fuernau, Suzanne de Waha
Aims: Evidence on the impact on clinical outcome of active mechanical circulatory support (MCS) devices in cardiogenic shock (CS) is scarce. This collaborative meta-analysis of randomized trials thus aims to investigate the efficacy and safety of percutanzeous active MCS vs. control in CS. Methods and results: Randomized trials comparing percutaneous active MCS to control in patients with CS were identified through searches of medical literature databases. Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated to analyse the primary endpoint of 30-day mortality and device-related complications including bleeding and leg ischaemia...
July 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019615/haemodynamic-profiles-of-children-with-end-stage-heart-failure
#5
Sharon Chen, John C Dykes, Doff B McElhinney, Robert J Gajarski, Andrew Y Shin, Seth A Hollander, Melanie E Everitt, Jack F Price, Ravi R Thiagarajan, Steven J Kindel, Joseph W Rossano, Beth D Kaufman, Lindsay J May, Elizabeth Pruitt, David N Rosenthal, Christopher S Almond
Aims: To evaluate associations between haemodynamic profiles and symptoms, end-organ function and outcome in children listed for heart transplantation. Methods and results: Children <18 years listed for heart transplant between 1993 and 2013 with cardiac catheterization data [pulmonary capillary wedge pressure (PCWP), right atrial pressure (RAP), and cardiac index (CI)] in the Pediatric Heart Transplant Study database were included. Outcomes were New York Heart Association (NYHA)/Ross classification, renal and hepatic dysfunction, and death or clinical deterioration while on waitlist...
October 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28993841/extent-of-jugular-venous-distension-and-lower-extremity-edema-are-the-best-tools-from-history-and-physical-examination-to-identify-heart-failure-exacerbation
#6
H R Omar, M Guglin
INTRODUCTION: We aimed to identify the best tools from history and physical examination that predict severity of heart failure (HF) exacerbation among patients with an ejection fraction (EF) ≤ 30%. METHODS: Patients enrolled in the ESCAPE trial were divided into tertiles according to the combined value of pulmonary capillary wedge pressure (PCWP) and right atrial pressure (RAP) which we used as a marker of volume loading of both pulmonary and systemic compartments...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28949052/resting-and-exercise-haemodynamics-in-relation-to-six-minute-walk-test-in-patients-with-heart-failure-and-preserved-ejection-fraction
#7
Emil Wolsk, David Kaye, Barry A Borlaug, Daniel Burkhoff, Dalane W Kitzman, Jan Komtebedde, Carolyn S P Lam, Piotr Ponikowski, Sanjiv J Shah, Finn Gustafsson
AIMS: Patients with heart failure and preserved ejection fraction (HFpEF) are characterized by functional impairment and an abnormal haemodynamic response to exercise. The six-minute walk test (6MWT) serves as a standardized test for functional capacity quantification in heart failure patients, and is associated with cardiovascular outcomes. However, as the association between 6MWT and haemodynamic parameters during rest and exercise in HFpEF patients is unknown, we sought to elucidate this relationship...
September 26, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28939932/prognostic-value-of-selected-echocardiographic-impedance-cardiographic-and-hemodynamic-parameters-determined-during-right-heart-catheterization-in-patients-qualified-for-heart-transplantation
#8
Wojciech Gilewski, Jarosław Pietrzak, Joanna Banach, Robert Bujak, Jan Błażejewski, Danuta Karasek, Łukasz Wołowiec, Władysław Sinkiewicz
The aim of the study was to verify prognostic value of selected echocardiographic (UKG), impedance cardiography (ICG), and right heart catheterization (RHC) parameters in systolic heart failure (HF). UKG, ICG, and RHC were performed in 46 patients with chronic HF with ejection fraction <35%. During a 1-year follow-up, composite endpoint (death or hospitalization due to HF exacerbation) was achieved by 23 (50.0%) patients. Analysis of receiver operating characteristic (ROC) curves identified UKG parameters: inferior vena cava diameter on inspiration (IVCinsp) >13 mm [area under curve (AUC), 0...
September 22, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28932571/management-of-pulmonary-hypertension-from-left-heart-disease-in-candidates-for-orthotopic-heart-transplantation
#9
REVIEW
Anna Koulova, Alan L Gass, Saikrishna Patibandla, Chhaya Aggarwal Gupta, Wilbert S Aronow, Gregg M Lanier
Pulmonary hypertension in left heart disease (PH-LHD) commonly complicates prolonged heart failure (HF). When advanced, the PH becomes fixed or out of proportion and is associated with increased morbidity and mortality in patients undergoing orthotopic heart transplant (OHT). To date, the only recommended treatment of out of proportion PH is the treatment of the underlying HF by reducing the pulmonary capillary wedge pressure (PCWP) with medications and often along with use of mechanical circulatory support...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28809670/cardio-pulmonary-stethoscope-clinical-validation-with-heart-failure-and-hemodialysis-patients
#10
Magdy F Iskander, Todd B Seto, Ruthsenne Rg Perron, Eunjung Lim, Farhan Qazi
OBJECTIVE: The purpose of this study is to evaluate the accuracy of a noninvasive radiofrequency-based device, the Cardio-Pulmonary Stethoscope (CPS), to monitor heart and respiration rates and detect changes in lung water content in human experiments and clinical trials. METHODS: Three human populations (healthy subjects (n=4), heart failure (n=12) and hemodialysis (n=13) patients) were enrolled in this study. The study was conducted at the University of Hawaii and The Queen's Medical Center in Honolulu, HI...
August 14, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28754567/usefulness-of-pulse-amplitude-changes-during-the-valsalva-maneuver-measured-using-finger-photoplethysmography-to-identify-elevated-pulmonary-capillary-wedge-pressure-in-patients-with-heart-failure
#11
Nisha A Gilotra, Ryan J Tedford, Ilan S Wittstein, Gayane Yenokyan, Kavita Sharma, Stuart D Russell, Harry A Silber
The pulse amplitude ratio, the ratio of pulse pressure at the end of a Valsalva maneuver to before the onset of Valsalva, correlates with filling pressure. This study aimed to noninvasively estimate cardiac filling pressure in patients with heart failure. We developed a noninvasive handheld device to measure pulse amplitude ratio using finger photoplethysmography. In 69 patients who underwent right heart catheterization, photoplethysmography waveforms were recorded during a standardized Valsalva maneuver, and in 60 of these patients, pulse amplitude ratio was able to be calculated...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#12
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28690287/stroke-volume-variation-svv-and-pulse-pressure-variation-ppv-as-indicators-of-fluid-responsiveness-in-sevoflurane-anesthetized-mechanically-ventilated-euvolemic-dogs
#13
Yusuke Endo, Jun Tamura, Tomohito Ishizuka, Takaharu Itami, Kiwamu Hanazono, Kenjiro Miyoshi, Tadashi Sano, Kazuto Yamashita, William W Muir
Changes in stroke volume variation (SVV) and pulse pressure variation (PPV) in response to fluid infusion were experimentally evaluated during vecuronium infusion and sevoflurane anesthesia in 5 adult, mechanically ventilated, euvolemic, beagle dogs. Sequential increases in central venous pressure (CVP; 3-7[baseline], 8-12, 13-17, 18-22 and 23-27 mmHg) were produced by infusing lactated Ringer's solution and 6% hydroxyethyl starch solution. Heart rate (beats/min), right atrial pressure (RAP, mmHg), pulmonary arterial pressure (PAP, mmHg), pulmonary capillary wedge pressure (PCWP, mmHg), transpulmonary thermodilution cardiac output (TPTDCO, l/min), stroke volume (SV, ml/beat), arterial blood pressure (ABP, mmHg), extravascular lung water (EVLW, ml), pulmonary vascular permeability index (PVPI, calculated), SVV (%), PPV (%) and systemic vascular resistance (SVR, dynes/sec/cm(5)) were determined at each predetermined CVP range...
August 18, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28677877/a-phase-2a-dose-escalation-study-of-the-safety-tolerability-pharmacokinetics-and-haemodynamic-effects-of-bms-986231-in-hospitalized-patients-with-heart-failure-with-reduced-ejection-fraction
#14
Cristina Tita, Edward M Gilbert, Adrian B Van Bakel, Jacek Grzybowski, Garrie J Haas, Mohammad Jarrah, Stephanie H Dunlap, Stephen S Gottlieb, Marc Klapholz, Parag C Patel, Roman Pfister, Tim Seidler, Keyur B Shah, Tomasz Zieliński, Robert P Venuti, Douglas Cowart, Shi Yin Foo, Alexander Vishnevsky, Veselin Mitrovic
AIMS: This study was designed to evaluate the safety, tolerability and haemodynamic effects of BMS-986231, a novel second-generation nitroxyl donor with potential inotropic, lusitropic and vasodilatory effects in patients hospitalized with decompensated heart failure and reduced ejection fraction (HFrEF). METHODS AND RESULTS: Forty-six patients hospitalized with decompensated HFrEF were enrolled into four sequential dose-escalation cohorts in this double-blind, randomized, placebo-controlled Phase 2a study...
July 5, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28665826/unrecognized-left-heart-failure-in-lvad-recipients-the-role-of-routine-invasive-hemodynamic-testing
#15
Palak Shah, Nina Badoe, Sheila Phillips, Kamil Abdullah, Christopher W May, Jose L Nabut, Ramesh Singh, Christopher deFilippi, Shashank S Desai
The role of routine right heart catheterizations (RHCs) in left ventricular assist device (LVAD) patients is undefined. We analyzed 105 continuous-flow LVAD recipients who underwent an RHC approximately 3 months after implant. In 38 patients, LVAD speed was ramped with the goal of optimizing hemodynamics. Our cohort consisted of 71 (68%) HeartMate II (HMII) and 34 (32%) HeartWare (HVAD) patients. Thirty patients (29%) had either a reduced cardiac index (CI ≤ 2.2 L/min/m), elevated pulmonary capillary wedge pressure (PCWP > 18 mm Hg), or both...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28664601/left-atrial-strain-predicts-hemodynamic-parameters-in-cardiovascular-patients
#16
Bernd Hewing, Lena Theres, Sebastian Spethmann, Karl Stangl, Henryk Dreger, Fabian Knebel
BACKGROUND: We aimed to evaluate the predictive value of left atrial (LA) reservoir, conduit, and contractile function parameters as assessed by speckle tracking echocardiography (STE) for invasively measured hemodynamic parameters in a patient cohort with myocardial and valvular diseases. METHODS: Sixty-nine patients undergoing invasive hemodynamic assessment were enrolled into the study. Invasive hemodynamic parameters were obtained by left and right heart catheterization...
August 2017: Echocardiography
https://www.readbyqxmd.com/read/28638961/evaluation-of-systolic-and-diastolic-properties-of-hypertensive-heart-failure-using-speckle-tracking-echocardiography-with-high-volume-rates
#17
Shingo Minatoguchi, Masanori Kawasaki, Ryuhei Tanaka, Takashi Yoshizane, Koji Ono, Maki Saeki, Maki Nagaya, Hidemaro Sato, Kazuhiko Nishigaki, Toshiyuki Noda, Michael R Zile, Shinya Minatoguchi
Left ventricular (LV) properties in hypertension (HTN) could be deteriorated by pressure overload, especially in endocardium, resulting in hypertensive heart failure (HHF). We sought to noninvasively examine LV systolic and diastolic functions at three myocardial layers in HTN and elucidate features of HHF by speckle-tracking echocardiography (STE) with high volume rates. We examined normotensive controls (n = 54), HTN patients without LV hypertrophy (LVH) (n = 50), and HTN patients with LVH (n = 40) and HHF patients (n = 45)...
June 21, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28625438/efficacy-of-prophylactic-doses-of-intravenous-nitroglycerin-in-preventing-myocardial-ischemia-under-general-anesthesia-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#18
REVIEW
Hiroshi Hoshijima, Yohei Denawa, Takahiro Mihara, Risa Takeuchi, Norifumi Kuratani, Tsutomu Mieda, Yoshinori Iwase, Toshiya Shiga, Zen'ichiro Wajima, Hiroshi Nagasaka
STUDY OBJECTIVE: To evaluate the efficacy of intravenous nitroglycerin (TNG) in preventing intraoperative myocardial ischemia (MI) under general anesthesia. Moreover, we analyzed the hemodynamic changes in heart rate (HR), mean blood pressure (MBP), and pulmonary capillary wedge pressure (PCWP) associated with TNG administration both before and after the induction of anesthesia. DESIGN: Meta-analysis. SETTING: Operating room, cardiac surgery or non-cardiac surgery, all surgeries were elective measurements...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625241/-efficacy-and-safety-of-intravenous-recombinant-human-brain-natriuretic-peptide-in-patients-with-severe-heart-failure-a-prospective-multicenter-clinical-study
#19
Xue Feng, Yue Wu, Ying Meng, Yizhen Wei
OBJECTIVE: To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). METHODS: A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade over III-IV, acute cardiac insufficiency and the acute exacerbation of chronic cardiac insufficiency admitted to intensive care unit/cardiovascular care unit (ICU/CCU) of 58 Hospitals in China were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28604571/hvad-waveform-analysis-as-a-noninvasive-marker-of-pulmonary-capillary-wedge-pressure-a-first-step-toward-the-development-of-a-smart-left-ventricular-assist-device-pump
#20
Jonathan Grinstein, Daniel Rodgers, Sara Kalantari, Gabriel Sayer, Gene H Kim, Nitasha Sarswat, Sirtaz Adatya, Takeyoshi Ota, Valluvan Jeevanandam, Daniel Burkhoff, Nir Uriel
Flow waveforms are an important feature of the HVAD left ventricular assist device (LVAD) that provides information about HVAD function and patient hemodynamics. We assessed the properties of one specific aspect of the waveform, the slope of the ventricular filling phase (VFP), and its correlation with pulmonary capillary wedge pressure (PCWP). A total of 101 screenshots from the HVAD monitor and simultaneous hemodynamic measurements were obtained simultaneously during sequential stages of invasive hemodynamic ramp studies...
June 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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