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decompensated heart failure

Pavel Hála, Mikuláš Mlček, Petr Ošťádal, David Janák, Michaela Popková, Tomáš Bouček, Stanislav Lacko, Jaroslav Kudlička, Petr Neužil, Otomar Kittnar
A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment methods. Here, we present such a model by tachycardia-induced cardiomyopathy, which can be produced by rapid cardiac pacing in swine. A single pacing lead is introduced transvenously into fully anaesthetized healthy swine, to the apex of the right ventricle, and fixated. Its other end is then tunneled dorsally to the paravertebral region. There, it is connected to an in-house modified heart pacemaker unit that is then implanted in a subcutaneous pocket...
February 17, 2018: Journal of Visualized Experiments: JoVE
Jorge Rubio-Gracia, Biniyam G Demissei, Jozine M Ter Maaten, John G Cleland, Christopher M O'Connor, Marco Metra, Piotr Ponikowski, John R Teerlink, Gad Cotter, Beth A Davison, Michael M Givertz, Daniel M Bloomfield, Howard Dittrich, Kevin Damman, Juan I Pérez-Calvo, Adriaan A Voors
BACKGROUND: Congestion is the main reason for hospital admission for acute decompensated heart failure (ADHF). A better understanding of the clinical course of congestion and factors associated with decongestion are therefore important. We studied the clinical course, predictors and prognostic value of congestion in a cohort of patients admitted for ADHF by including different indirect markers of congestion (residual clinical congestion, brain natriuretic peptides (BNP) trajectories, hemoconcentration or diuretic response)...
May 1, 2018: International Journal of Cardiology
Hiroyuki Takahama, Seiji Takashio, Toshio Nishikimi, Tomohiro Hayashi, Chiaki Nagai-Okatani, Yasuaki Nakagawa, Makoto Amaki, Takahiro Ohara, Takuya Hasegawa, Yasuo Sugano, Hideaki Kanzaki, Satoshi Yasuda, Kenji Kangawa, Naoto Minamino, Toshihisa Anzai
BACKGROUND: A recent study showed that both glycosylation of pro-B-type natriuretic peptide (BNP) and the proBNP/total BNP ratio are decreased in acute decompensated heart failure (ADHF). However, the following points regarding the proBNP/total BNP ratio have not been determined in patients with ADHF: 1) the relationship with the severity of ADHF, 2) the changes in the ratio during treatment, and 3) the relationship with cyclic guanosine monophosphate (cGMP)-generating activity. METHODS: Plasma proBNP and total BNP (proBNP+mature BNP) were measured in patients with ADHF (n=154)...
May 1, 2018: International Journal of Cardiology
Juliano Novaes Cardoso, Carlos Henrique Del Carlo, Mucio Tavares de Oliveira Junior, Marcelo Eidi Ochiai, Roberto Kalil Filho, Antônio Carlos Pereira Barretto
BACKGROUND: Heart failure (HF) is a syndrome, whose advanced forms have a poor prognosis, which is aggravated by the presence of comorbidities. OBJECTIVE: We assessed the impact of infection in patients with decompensated HF admitted to a tertiary university-affiliated hospital in the city of São Paulo. METHODS: This study assessed 260 patients consecutively admitted to our unit because of decompensated HF. The presence of infection and other morbidities was assessed, as were in-hospital mortality and outcome after discharge...
March 12, 2018: Arquivos Brasileiros de Cardiologia
Kevin Kuriakose, Whitney Jones-Nesbitt, Matthew Greene, Bryan Harris
A woman in her late 60s with disseminated histoplasmosis was treated with posaconazole since first-line therapies were not tolerated. She subsequently presented with decompensated heart failure, hypertension, and hypokalemia. Labs revealed low renin and aldosterone levels. A potential mechanism is inhibition of the enzyme 11 beta-hydroxysteroid dehydrogenase 2, with resultant apparent mineralocorticoid excess.
March 12, 2018: Antimicrobial Agents and Chemotherapy
Eli Muchtar, Morie A Gertz, Shaji K Kumar, Grace Lin, Barry Boilson, Alfredo Clavell, Martha Q Lacy, Francis K Buadi, Suzanne R Hayman, Prashant Kapoor, David Dingli, S Vincent Rajkumar, Angela Dispenzieri, Martha Grogan
AIM: Digoxin is considered contraindicated in light-chain (AL) amyloidosis, given reports of increased toxicity published 30-50 years ago. We sought to determine the frequency of digoxin toxicity in patients with AL. METHODS: We identified 107 patients with AL amyloidosis who received digoxin between 2000 and 2015. RESULTS: The median age was 65 and the median digoxin dose and estimated glomerular filtration rate were 0.125 mg/d and 55 ml/min/1...
March 12, 2018: Amyloid: the International Journal of Experimental and Clinical Investigation
P Kala, L Sedláková, P Škaroupková, L Kopkan, Z Vaňourková, M Táborský, A Nishiyama, S H Hwang, B D Hammock, J Sadowski, V Melenovský, J D Imig, L Červenka
We showed recently that increasing kidney epoxyeicosatrienoic acids (EETs) by blocking soluble epoxide hydrolase (sEH), an enzyme responsible for EETs degradation, retarded the development of renal dysfunction and progression of aorto-caval fistula(ACF)-induced congestive heart failure (CHF) in Ren-2 transgenic hypertensive rats (TGR). In that study the final survival rate of untreated ACF TGR was only 14 % but increased to 41 % after sEH blockade. Here we examined if sEH inhibition added to renin-angiotensin system (RAS) blockade would further enhance protection against ACF-induced CHF in TGR...
March 12, 2018: Physiological Research
Ajith Ananthakrishna Pillai, Chandramohan Ramasamy, Saranya Gousy V, Harichandrakumar Kottyath
BACKGROUND: Mitral stenosis may present with decompensated heart failure during pregnancy. Many patients do have advanced sub valve disease and present late with decompensated state. The outcomes of balloon mitral valvuloplasty (BMV) in such advanced sub valve disease with severe heart failure in pregnancy has not been specifically studied till now. METHODS: A descriptive study looking at the immediate and long-term outcomes of pregnant patients with MS who presented with severe heart failure and sub valve disease who had undergone BMV...
March 11, 2018: Journal of Interventional Cardiology
Lukasz P Cerbin, Andrew P Ambrosy, Stephen J Greene, Paul W Armstrong, Javed Butler, Adrian Coles, Adam D DeVore, Justin A Ezekowitz, Adrian F Hernandez, Marco Metra, Randall C Starling, Wilson Tang, John R Teerlink, Adriaan A Voors, Angie Wu, Christopher M O'Connor, Robert J Mentz
OBJECTIVES: As the largest acute heart failure (AHF) trial conducted to date, the global ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial database presented an opportunity to systematically describe the relationship among time of hospital presentation, clinical profile, inpatient management, and outcomes among patients admitted with AHF. BACKGROUND: Time of hospital presentation has been shown to impact outcomes among patients hospitalized with many conditions...
March 7, 2018: JACC. Heart Failure
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
Kegan J Moneghetti, Julia Hock, Leonard Kaminsky, Ross Arena, George K Lui, Francois Haddad, Matthew Wheeler, Victor Froelicher, Euan Ashley, Jonathan Myers, Jeffrey W Christle
INTRODUCTION: Percent of predicted peak VO2 (ppVO2 ) is considered a standard measure for establishing disease severity, however, there are known limitations to traditional normative values. This study sought to compare ppVO2 from the newly derived "Fitness Registry and the Importance of Exercise: a National Database" (FRIEND) registry equation to conventional prediction equations in a clinical cohort of patients undergoing cardiopulmonary exercise testing (CPX). METHODS AND RESULTS: We selected 1094 patients referred for evaluation of heart failure (HF) symptoms who underwent CPX...
February 27, 2018: International Journal of Cardiology
Masato Matsushita, Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Hirotake Okazaki, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kazutaka Kiuchi, Kuniya Asai, Wataru Shimizu
BACKGROUND: The association between social factors and the long-term prognosis of acute heart failure (AHF) remains unclear. METHODS AND RESULTS: One thousand fifty-one AHF patients were screened, and 915 were enrolled. Four hundred forty-two AHF patients ≥75 years of age (the elderly cohort) were also included in a sub-analysis. Participants who fulfilled one of the three marital status-, offspring-, and living status-related criteria were considered socially vulnerable...
March 6, 2018: Journal of Cardiology
Ahmed Subahi, Walid Ibrahim, Ashraf Abugroun
CLINICAL FEATURES: The patient we present is a 39-year-old woman with a history of hyperthyroidism who developed fast atrial fibrillation secondary to thyrotoxic storm. After the initiation of intravenous diltiazem drip, she developed hypotension, bradycardia, then asystole cardiac arrest. THERAPEUTIC CHALLENGE: It is well known that calcium channel blockers and beta blockers should be used with extreme caution if the patient with thyroid storm has decompensated heart failure with reduced ejection fraction...
February 28, 2018: American Journal of Therapeutics
Patricia P Chang, Lisa M Wruck, Eyal Shahar, Joseph S Rossi, Laura R Loehr, Stuart D Russell, Sunil K Agarwal, Suma H Konety, Carlos J Rodriguez, Wayne D Rosamond
Background -Community trends of acute decompensated heart failure (ADHF) in diverse populations may differ by race and sex. Methods -The Atherosclerosis Risk in Communities (ARIC) Study sampled heart failure related hospitalizations (age ≥55 years) in four US communities from 2005-2014 using ICD-9-CM codes. ADHF hospitalizations were validated by standardized physician review and computer algorithm, yielding 40,173 events after accounting for sampling design (unweighted n=8746). Results -Of the ADHF hospitalizations, 50% had reduced ejection fraction (HFrEF), 39% had preserved EF (HFpEF)...
March 8, 2018: Circulation
Luke D Plant, David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K Patel, Douglas F Johnson, Louise M Burrell
BACKGROUND: We aimed to investigate the incidence, precipitants, and outcomes of acute decompensated heart failure (ADHF) that develops during the inpatient stay. METHODS: We undertook a case-control study in the medical, oncology, surgical, and orthopaedic wards of a tertiary referral hospital (February-May, 2016). Patients aged ≥18 years who developed ADHF during their inpatient stay were enrolled as cases. One control patient was matched to each case by age, gender, presenting complaint/surgery performed and co-morbidities...
December 23, 2017: Heart, Lung & Circulation
H R Omar, M Guglin
BACKGROUND: The B‑type natriuretic peptide (BNP) level on discharge of patients hospitalized with decompensated heart failure (HF) is widely considered as the "baseline" value, and treatment should be targeted to maintain this level. The prognostic value of an increase in BNP level from discharge to the 1‑month follow-up in predicting rehospitalization has not been previously explored. METHODS: The Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial data were utilized to determine whether an increase in BNP level from discharge to the 1‑month follow-up is associated with a higher risk of rehospitalization...
March 7, 2018: Herz
Shin Watanabe, Kenneth Fish, Jason C Kovacic, Olympia Bikou, Lauren Leonardson, Koichi Nomoto, Jaume Aguero, Navin K Kapur, Roger J Hajjar, Kiyotake Ishikawa
BACKGROUND: Delivering therapeutic materials, like stem cells or gene vectors, to the myocardium is difficult in the setting of ischemic heart failure because of decreased coronary flow and impaired microvascular perfusion (MP). The aim of this study was to determine if mechanical left ventricular (LV) unloading with the Impella increases coronary flow and MP in a subacute myocardial infarction. METHODS AND RESULTS: Anterior transmural myocardial infarction (infarct size, 26...
March 7, 2018: Journal of the American Heart Association
Tae Soo Kang, Byung Soo Ko, Stavros G Drakos, Josef Stehlik, Steven I Bott, Antigone Koliopoulou, Joseph E Tonna, Megan E Bowen, Kathleen Stoddard, Craig H Selzman, Stephen H McKellar
BACKGROUND: Acute mechanical circulatory support (aMCS) can be a lifesaving therapy for patients with refractory cardiogenic shock. As device safety and technology improve, so will the ability to extend aMCS to patients at remote hospitals. The Intermountain West is unique because of the large geographical area, making transport of critically ill patients a logistical challenge. METHODS: We reviewed our experience of transporting patients in cardiogenic shock over long distances who had already been placed on aMCS: Impella and extracorporeal membrane oxygenator devices...
April 2018: Journal of Surgical Research
Zulfiqar Qutrio Baloch, Muhammad Hussain, Shabber Agha Abbas, Jorge L Perez, Muhammad Ayyaz
The development of methamphetamine-associated cardiomyopathy (MACM) represents a severe complication of chronic methamphetamine abuse. MACM-induced irreversible structural and functional changes in the heart can eventually lead to decompensated heart failure, ultimately requiring heart transplantation. In this case report we present a 47-year old male with a previous history of chronic amphetamine abuse who presented to the emergency room with severe dyspnea at rest associated with mild substernal non-radiating chest pain...
2018: Emergency (Tehran, Iran)
Akiomi Yoshihisa, Satoshi Abe, Takatoyo Kiko, Yusuke Kimishima, Yu Sato, Shunsuke Watanabe, Yuki Kanno, Makiko Miyata-Tatsumi, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Takafumi Ishida, Yasuchika Takeishi
BACKGROUND: Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF). METHODS AND RESULTS: We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into three groups based on serum zinc levels (µg/dl): 1st (zinc≥75, n=323), 2nd (62≤zinc<75, n=322) and 3rd (zinc<62, n=323) tertiles...
March 1, 2018: Journal of Cardiac Failure
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