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https://www.readbyqxmd.com/read/28932571/management-of-pulmonary-hypertension-from-left-heart-disease-in-candidates-for-orthotopic-heart-transplantation
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28597763/open-label-study-of-ambrisentan-in-patients-with-exercise-pulmonary-hypertension
#13
Sergio A Segrera, Laurie Lawler, Alexander R Opotowsky, David Systrom, Aaron B Waxman
A growing body of evidence suggests that exercise pulmonary hypertension (ePH) is an early form of pulmonary arterial hypertension (PAH). Identifying the disease at an early, potentially more responsive phase, and initiating treatment may improve functional status and prevent progression to severe forms of PAH. This was a single-center, open-label six-month treatment trial to evaluate the effect of ambrisentan on pulmonary hemodynamics and exercise capacity in ePH utilizing invasive cardiopulmonary exercise testing (iCPET)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28592749/dynamics-of-oxidative-stress-evoked-by-myocardial-ischemia-reperfusion-after-off-pump-coronary-artery-bypass-grafting-elucidated-by-bilirubin-oxidation
#14
Masaki Yamamoto, Hideaki Nishimori, Takashi Fukutomi, Tokio Yamaguchi, Kazumasa Orihashi
BACKGROUND: Revascularization therapy relieves myocardial ischemia, but can also result in ischemia-reperfusion injury caused by oxidative stress. However, the biokinetics of oxidative stress after myocardial ischemia-reperfusion are uncertain. This study aimed to evaluate the dynamics of oxidative stress after off-pump coronary artery bypass grafting (OPCAB) by measuring urinary biopyrrin levels. Biopyrrin is an oxidative metabolite of bilirubin thought to reflect oxidative stress, along with reactive nitrogen species (RNS)...
June 8, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28492790/effects-of-low-dose-recombinant-human-brain-natriuretic-peptide-on-anterior-myocardial-infarction-complicated-by-cardiogenic-shock
#15
RANDOMIZED CONTROLLED TRIAL
Yesheng Pan, ZhiGang Lu, Jingyu Hang, Shixin Ma, Jian Ma, Meng Wei
INTRODUCTION: The mortality due to cardiogenic shock complicating acute myocardial infarction (AMI) is high even in patients with early revascularization. Infusion of low dose recombinant human brain natriuretic peptide (rhBNP) at the time of AMI is well tolerated and could improve cardiac function. OBJECTIVE: The objective of this study was to evaluate the hemodynamic effects of rhBNP in AMI patients revascularized by emergency percutaneous coronary intervention (PCI) who developed cardiogenic shock...
March 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28435003/the-hemodynamic-effects-of-aortic-insufficiency-in-patients-supported-with-continuous-flow-left-ventricular-assist-devices
#16
Gabriel Sayer, Nitasha Sarswat, Gene H Kim, Sirtaz Adatya, Diego Medvedofsky, Daniel Rodgers, Eric Kruse, Takeyoshi Ota, Valluvan Jeevanandam, Roberto Lang, Nir Uriel
BACKGROUND: The impact of aortic insufficiency (AI) on the morbidity and mortality of left ventricular assist device (LVAD) patients remains controversial. This study's aim was to assess the hemodynamics of LVAD patients with at least mild AI, at baseline and in response to device speed changes. METHODS AND RESULTS: Asymptomatic LVAD patients were prospectively enrolled and underwent a hemodynamic and echocardiographic ramp study. Hemodynamics at rest and in response to device speed changes were compared between patients with at least mild AI at their baseline speed and patients without AI...
April 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28400191/impact-of-pulmonary-capillary-wedge-pressure-on-long-term-mortality-in-patients-with-pulmonary-arterial-hypertension-treated-with-parenteral-trepostinil
#17
Jignesh K Patel, Youlan Rao, Paul Strachan
BACKGROUND: The clinical impact of pulmonary capillary wedge pressure (PCWP) on long-term mortality among patients with pulmonary arterial hypertension (PAH) has been incompletely reported, particularly in relation to concomitant treprostinil administration. The goal of this study was to assess the impact of PCWP on long-term mortality in PAH patients treated with parenteral treprostinil. METHODS: We studied a cohort of 743 patients with PAH treated with parenteral treprostinil therapy...
March 22, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28393781/comparison-of-levosimendan-versus-dobutamine-in-patients-with-moderate-to-severe-left-ventricular-dysfunction-undergoing-off-pump-coronary-artery-bypass-grafting-a-randomized-prospective-study
#18
Ashok Kandasamy, Hariharan Antony Simon, P Murthy, Mahalakshmi Annadurai, Mushkath Mohamed Ali, Gayathri Ramanathan
CONTEXT: Recent upsurge in referral of patients with compromised left ventricular (LV) function for cardiac surgery has led to an increasing use inotropes to achieve improvement of tissue perfusion in the perioperative period. AIMS AND OBJECTIVES: To compare the hemodynamic effects and immediate postoperative outcomes with levosimendan and dobutamine in patients with moderate to severe LV dysfunction undergoing off-pump coronary artery bypass grafting (OPCAB). SETTINGS AND DESIGN: University teaching hospital, randomized control study...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28387860/prolonged-central-circulation-transit-time-in-patients-with-hfpef-and-hfref-by-magnetic-resonance-imaging
#19
Jie J Cao, Laura Li, Jeannette McLaughlin, Michael Passick
Aims: Prolonged central circulation transit time (TT) has long been associated with heart failure (HF) and left ventricular (LV) dysfunction. In this study, we assessed the central circulation TT using cardiovascular magnetic resonance imaging (CMR) in patients with HF of preserved ejection fraction (HFpEF) and of reduced EF (HFrEF) and investigated its relation to haemodynamics. Methods and results: Fifty eight prospectively recruited volunteers underwent CMR. TT was taken as the time between the peaks of time-intensity curves from first pass perfusion images and normalized to cardiac cycle length intervals...
April 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28344613/anp-and-bnp-plasma-levels-in-patients-with-rheumatic-mitral-stenosis-after-percutaneous-balloon-mitral-valvuloplasty
#20
Łukasz Mazurkiewicz, Witold Rużyłło, Zbigniew Chmielak, Ewa Opalińska-Ciszek, Jadwiga Janas, Piotr Hoffman, Tomasz Hryniewiecki, Jacek Grzybowski
INTRODUCTION: Atrial (ANP) and B-type (BNP) natriuretic peptides are hormones secreted by the heart as a response to volume expansion and pressure overload. AIM: To assess the changes of ANP and BNP after percutaneous balloon mitral valvuloplasty (PBMV) and to investigate factors associated with endpoints. MATERIAL AND METHODS: The study included 96 patients (90.7% females, age 51.6 ±12.2 years) with rheumatic mitral valve stenosis (mitral valve area (MVA) 1...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
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