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https://www.readbyqxmd.com/read/29351635/reversibility-of-severe-mitral-valve-regurgitation-after-left-ventricular-assist-device-implantation-single-centre-observations-from-a-real-life-population-of-patients
#1
Monica Dobrovie, Ricardo A Spampinato, Elena Efimova, Jaqueline G da Rocha E Silva, Julia Fischer, Michael Kuehl, Jens-Uwe Voigt, Ann Belmans, Agnieszka Ciarka, Fernanda Bonamigo Thome, Valerie Schloma, Yaroslava Dmitrieva, Sven Lehmann, Jochen Hahn, Elfriede Strotdrees, Friedrich-Wilhelm Mohr, Jens Garbade, Anna L Meyer
OBJECTIVES: This study evaluates the impact of untreated preoperative severe mitral valve regurgitation (MR) on outcomes after left ventricular assist device (LVAD) implantation. METHODS: Of the 234 patients who received LVAD therapy in our centre during a 6-year period, we selected those who had echocardiographic images of good quality and excluded those who underwent mitral valve replacement prior to or mitral valve repair during LVAD placement. The 128 patients selected were divided into 2 groups: Group A with severe MR (n = 65) and Group B with none to moderate MR (n = 63, 28 with moderate MR)...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29349805/hybrid-continuous-flow-total-artificial-heart
#2
Carson Fox, Steven Chopski, Nohra Murad, Paul Allaire, Robert Mentzer, Joseph Rossano, Francisco Arabia, Amy Throckmorton
Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29348023/impaired-recovery-of-left-ventricular-function-in-patients-with-cardiomyopathy-and-left%C3%A2-bundle-branch-block
#3
Edward Sze, Zainab Samad, Allison Dunning, Kristen Bova Campbell, Zak Loring, Brett D Atwater, Karen Chiswell, Joseph A Kisslo, Eric J Velazquez, James P Daubert
BACKGROUND: Patients with left bundle branch block (LBBB) often respond to cardiac resynchronization therapy (CRT) with left ventricular ejection fraction (LVEF) improvement. Guideline-directed medical therapy (GDMT), not CRT, is first-line therapy for patients with reduced LVEF with LBBB. However, there are little data on how patients with reduced LVEF and LBBB respond to GDMT. OBJECTIVES: This study examined patients with cardiomyopathy and sought to assess rates of LVEF improvement for patients with LBBB compared to other QRS morphologies...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29345584/mechanical-support-in-cardiogenic-shock-complicating-acute-coronary-syndrome-ready-for-prime-time
#4
Guillaume Schurtz, Marc Laine, Clement Delmas, Francois Kerbaul, Etienne Puymirat, Gilles Lemesle, Laurent Bonello
Cardiogenic shock (CS) is a major challenge in current cardiology. Over the last decade, cardiogenic shock mortality has decreased somewhat, but it still remains high, particularly when associated with ischaemic heart disease. The challenges are numerous and include prevention, accurate diagnosis, prompt management and effective therapies to support a failing heart and prevent multi-organ failure. Despite improvements in the care of acute coronary syndrome (ACS), it remains the most common cause of CS. In addition to existing medical therapy, mechanical circulatory support has been proposed for the management of ventricular failure...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29342243/devices-in-heart-failure-diagnosis-detection-and-disease-modification
#5
John Gierula, Mark T Kearney, Klaus K Witte
Introduction/background: Implantable cardiac devices are widely used in chronic heart failure (CHF) therapy. This review covers current CHF treatment with electronic cardiac devices, areas of discussion and emerging technologies. Sources of data: A comprehensive search of available literature resources including Pubmed, MEDLINE and EMBASE was performed. National and international guidelines were accessed. Areas of agreement: Excessive right ventricular pacing is detrimental to cardiac function...
January 12, 2018: British Medical Bulletin
https://www.readbyqxmd.com/read/29338859/renal-function-and-outcome-after-heart-transplantation
#6
Oscar Kolsrud, Kristjan Karason, Erik Holmberg, Sven-Erik Ricksten, Marie Felldin, Ola Samuelsson, Göran Dellgren
OBJECTIVES: To investigate whether measured glomerular filtration rate (mGFR) is a risk factor for death and/or end-stage renal disease (ESRD) after heart transplantation (HTx). METHODS: All adult patients (n = 416) who underwent HTx between 1988 and 2010 were included. mGFR was performed both preoperatively and postoperatively as annual follow-up. Eight patients received a concomitant kidney transplant (KTx), and 15 underwent late KTx due to chronic renal failure after HTx...
December 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338475/advances-in-atrioventricular-and-interventricular-optimization-of-cardiac-resynchronization-therapy-what-s-the-gold-standard
#7
Matthew K Rowe, Gerald C Kaye
Cardiac resynchronization therapy (CRT) is one of the most important advances in heart failure management in the last twenty years. Approximately one-third of patients appear not to respond to therapy. Although there are a number of possible mechanisms for non-response, an important factor is suboptimal atrioventricular (AV) and interventricular (VV) timing intervals. There remains controversy over whether routinely optimizing intervals is necessary and there is no agreed gold standard methodology. Optimization has classically been performed using echocardiography which has limits related to resource use, time-cost and variable reproducibility...
January 16, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29334508/practical-valvular-issues-in-patients-requiring-ventricular-assist-devices
#8
Mitesh Badiwala, Terrence Yau
PURPOSE OF REVIEW: As ventricular assist device (VAD) therapy in patients with advanced heart failure continues to grow, experience with concomitant valvular diseases present either before or after VAD implantation continues to accrue. In this review, we discuss recent data and current practice as it pertains to the subject of concomitant valvular disease in patients requiring VADs. RECENT FINDINGS: Persistent aortic valve closure has been identified as a potential contributor to aortic valve 'disuse atrophy' resulting in valve degeneration...
January 13, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29327314/computational-modeling-for-cardiac-resynchronization-therapy
#9
Angela W C Lee, Caroline Mendonca Costa, Marina Strocchi, Christopher A Rinaldi, Steven A Niederer
Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) patients with an electrical substrate pathology causing ventricular dyssynchrony. However 40-50% of patients do not respond to treatment. Cardiac modeling of the electrophysiology, electromechanics, and hemodynamics of the heart has been used to study mechanisms behind HF pathology and CRT response. Recently, multi-scale dyssynchronous HF models have been used to study optimal device settings and optimal lead locations, investigate the underlying cardiac pathophysiology, as well as investigate emerging technologies proposed to treat cardiac dyssynchrony...
January 11, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29326129/machine-learning-algorithm-predicts-cardiac-resynchronization-therapy-outcomes-lessons-from-the-companion-trial
#10
Matthew M Kalscheur, Ryan T Kipp, Matthew C Tattersall, Chaoqun Mei, Kevin A Buhr, David L DeMets, Michael E Field, Lee L Eckhardt, C David Page
BACKGROUND: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure patients with reduced left ventricular function and intraventricular conduction delay. However, individual outcomes vary significantly. This study sought to use a machine learning algorithm to develop a model to predict outcomes after CRT. METHODS AND RESULTS: Models were developed with machine learning algorithms to predict all-cause mortality or heart failure hospitalization at 12 months post-CRT in the COMPANION trial (Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure)...
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29325978/management-of-cardiac-implantable-electronic-devices-in-the-presence-of-left-ventricular-assist-devices
#11
Valay Parikh, Andrew Sauer, Paul Friedman, Seth H Sheldon
Left ventricular assist devices (LVAD) are increasingly utilized in the management of patients with advanced heart failure. Many of these patients have or will be considered for cardiac implantable electronic devices (CIEDs) such as an implantable cardioverter-defibrillator or cardiac resynchronization therapy device. Frequent interplay is often encountered due to complexity of these devices and the underlying disease states. Proactive management strategies and an awareness of interactions may help reduce adverse events...
January 8, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29324309/the-promising-future-of-ventricular-restraint-therapy-for-the-management-of-end-stage-heart-failure
#12
REVIEW
Muhammad Naveed, Imran Shair Mohammad, Li Xue, Sara Khan, Wang Gang, Yanfang Cao, Yijie Cheng, Xingxing Cui, Chen DingDing, Yu Feng, Wang Zhijie, Zhou Xiaohui
Complicated pathophysiological syndrome associated with irregular functioning of the heart leading to insufficient blood supply to the organs is linked to congestive heart failure (CHF) which is the leading cause of death in developed countries. Numerous factors can add to heart failure (HF) pathogenesis, including myocardial infarction (MI), genetic factors, coronary artery disease (CAD), ischemia or hypertension. Presently, most of the therapies against CHF cause modest symptom relief but incapable of giving significant recovery for long-term survival outcomes...
January 8, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29319565/left-ventricular-assist-device-as-destination-therapy-for-end-stage-heart-failure-the-right-time-for-the-right-patients
#13
Naoto Fukunaga, Vivek Rao
PURPOSE OF REVIEW: Cardiac transplantation is the gold standard treatment for patients with end-stage heart failure. Unfortunately, the demand for donor organs far outstrips the number of available hearts. Therefore, not all patients who can benefit from this therapy are even listed for transplant. Once destination therapy was approved for the long-term support of nontransplant eligible patients, it was felt that the number of durable ventricular assist device (VAD) implants would increase...
January 9, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29315424/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#14
Ammar M Killu, Jae-Yoon Park, Jaskanwal D Sara, David O Hodge, Bernard J Gersh, Rick A Nishimura, Samuel J Asirvatham, Christopher J McLeod
Aims: A dilated/end-stage phase of hypertrophic cardiomyopathy (HCM) is rare but well-recognized. The role for cardiac resynchronization therapy (CRT) in this subset of patients remains unexplored. We aimed to clarify the impact of bi-ventricular pacing CRT in dilated/end-stage HCM. Methods and results: The Mayo Clinic HCM database was interrogated to identify patients with ejection fraction (EF) <50% and CRT. Control subjects were identified in 1:1 manner...
January 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29302122/rvad-support-in-the-setting-of-submassive-pulmonary-embolism
#15
Antonio Salsano, Elena Sportelli, Guido Maria Olivieri, Nicola Di Lorenzo, Silvia Borile, Francesco Santini
Patients with submassive pulmonary embolism (PE), although normotensive, are characterized by right ventricular (RV) dysfunction and elevated levels of biomarkers of cardiac damage. The best treatment option in these cases is still a subject of debate and the use of thrombolysis in submassive PE remains controversial. A 57-year-old Caucasian male with unprovoked PE, normal blood pressure, and elevated troponin I values was referred to the cardiovascular department. In view of the presence of a right atrium thrombus, the patient underwent surgical embolectomy under extracorporeal circulation, with the extraction of a huge thrombus together with fragmented thrombi from both pulmonary arteries...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29300199/recent-advances-in-heart-failure
#16
Mahwash Kassi, Bashar Hannawi, Barry Trachtenberg
PURPOSE OF REVIEW: Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)...
January 2, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29287808/clinical-implications-of-hemodynamic-assessment-during-left-ventricular-assist-device-therapy
#17
REVIEW
Teruhiko Imamura, Ben Chung, Ann Nguyen, Gabriel Sayer, Nir Uriel
Left ventricular assist devices (LVADs) significantly improve outcomes of advanced heart failure patients. However, patients continue to have high readmission rates due to complications ranging from bleeding, thrombosis, heart failure, and infection. Considering that the hallmark benefit of LVAD therapy is improvement in hemodynamics (cardiac unloading and increased cardiac output), hemodynamic assessment on LVAD support is key to better understand these difficult complications and may serve as a tool to resolving them...
December 26, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29283915/diagnostic-power-and-healthcare-resource-consumption-of-a-dedicated-workflow-algorithm-designed-to-manage-thoracic-impedance-alerts-in-heart-failure-patients-by-remote-monitoring
#18
Renato P Ricci, Loredana Morichelli, Antonio Porfili, Laura Quarta, Anna Sassi
PURPOSE: Modern cardiac implantable devices provide diagnostic information on several physiological variables which are associated with worsening heart failure, creating an opportunity for early intervention to prevent heart failure symptoms and hospitalizations. We evaluated diagnostic accuracy and workload of a remote monitoring (RM) workflow algorithm which leverages intrathoracic impedance and other device diagnostics. METHODS: In our RM workflow a team of expert nurses was responsible for continuity of care, direct relationship with patients and implementation of a specific protocol to evaluate RM alerts and to limit unnecessary resource consumption...
December 27, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29275844/left-ventricular-assist-devices-versus-medical-management-in-ambulatory-heart-failure-patients-an-analysis-of-intermacs-profiles-4-and-5-to-7-from-the-roadmap-study
#19
Keyur B Shah, Randall C Starling, Joseph G Rogers, Douglas A Horstmanshof, James W Long, Vigneshwar Kasirajan, Josef Stehlik, Joyce Chuang, David J Farrar, Jerry D Estep
BACKGROUND: The ROADMAP study showed survival with improved functional status was better with left ventricular assist device (LVAD) therapy compared with optimal medical management (OMM) in ambulatory, non-inotrope-dependent (INTERMACS [IM] Profile 4 to 7) patients. To study more balanced cohorts and better define which patients may benefit from implantation of an LVAD, we re-evaluated the patients enrolled in ROADMAP when stratified by INTERMACS profile (Profile 4 and Profiles 5 to 7)...
December 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29274911/selective-implantation-of-durable-left-ventricular-assist-devices-as-primary-therapy-for-refractory-cardiogenic-shock
#20
Amit Pawale, Yosef Schwartz, Shinobu Itagaki, Sean Pinney, David H Adams, Anelechi C Anyanwu
OBJECTIVE: Surgical therapy for refractory primary cardiogenic shock is largely based on emergent placement of extracorporeal membrane oxygenation or short-term ventricular assist devices. We have adopted a strategy of routine implantation of durable left ventricular assist devices (LVAD) as initial therapy for refractory cardiogenic shock, in patients who are potential candidates for heart transplantation, and report our experience. METHODS: Retrospective review of 43 consecutive patients with refractory shock caused by acute myocardial infarction (n = 21) or acute decompensated heart failure (n = 22) who were treated with primary implantation of a durable LVAD in a single institution...
November 21, 2017: Journal of Thoracic and Cardiovascular Surgery
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