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https://www.readbyqxmd.com/read/29471574/-type-2-diabetes-diabetes-in-older-adults-example-for-patient-centered-drug-therapy
#1
Dirk Müller-Wieland
Diabetes in older adults has a high prevalence and is frequently associated with comorbidities of the cardiovascular system, dysfunction of cognition as well as depression and impaired mobility or increased frailty. Furthermore, impaired renal function, heart failure, risk for hypoglycemia and polypharmacy has to be considered in the decision about the diabetes treatment strategy. The goal of blood glucose management is driven by patient relevant issues and patient self-esteem, quality of life defined by the patient, preservation of physical and social mobility rather than potential long-term effects on reduction of cardio- and microvascular events in the future, which is limited by patient-inherent reduced life expectancy of the aged individual...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29471572/-cardiovascular-medication-in-elderly-patients
#2
Robert H G Schwinger
Elderly people show increased probability to develop atherosclerotic diseases; in consequence heart failure - most often following coronary heart disease - as well as atrial fibrillation is more common. Following guidelines may lead to polypharmacy, i. e. use of more than 5 drugs daily. Thus, drug interactions as well as side effects become more likely; especially in elderly patients reduced kidney function has to be taken into account. Only drugs which have shown to prolong life or to reduce symptoms in controlled clinical trials should be used...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29471442/estimation-of-adaptive-ventilation-success-and-failure-using-polysomnogram-and-outpatient-therapy-biomarkers
#3
Stacey Gunn, Sreelatha Naik, Matt Travis Bianchi, Robert Joseph Thomas
Study Objectives: Adaptive servo ventilation (ASV) devices provide anti-cyclic pressure support for treatment of central/complex sleep apnea, including in heart failure patients. Variability in responses in the clinic and negative clinical trials motivated assessment of standard and novel signal biomarkers for ASV efficacy. Methods: Multiple clinical databases were queried to assess potential signal biomarkers of ASV effectiveness, including 1) Attended laboratory adaptive ventilation titrations: 108, of which 66 had mainstream ETCO2 measurements...
February 17, 2018: Sleep
https://www.readbyqxmd.com/read/29470248/role-of-cardiovascular-imaging-in-cardiac-resynchronization-therapy-a-literature-review
#4
Biagio Sassone, Gaetano Nucifora, Donato Mele, Cinzia Valzania, Giovanni Bisignani, Giuseppe Boriani
: Cardiac resynchronization therapy (CRT) is an established treatment in patients with symptomatic drug-refractory heart failure and broad QRS complex on the surface ECG. Despite the presence of either mechanical dyssynchrony or viable myocardium at the site where delivering left ventricular pacing being necessary conditions for a successful CRT, their direct assessment by techniques of cardiovascular imaging, though feasible, is not recommended in clinical practice by the current guidelines. Indeed, even though there is growing body of data providing evidence of the additional value of an image-based approach as compared with routine approach in improving response to CRT, these results should be confirmed in prospective and large multicentre trials before their impact on CRT guidelines is considered...
February 20, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29470245/intra-aortic-balloon-pump-use-before-left-ventricular-assist-device-implantation-insights-from-the-intermacs-registry
#5
Adam D DeVore, Bradley G Hammill, Chetan B Patel, Manesh R Patel, Joseph G Rogers, Carmelo A Milano, Adrian F Hernandez
Use of durable, continuous-flow left ventricular assist devices (LVADs) has expanded rapidly, although data are limited regarding optimization strategies before LVAD implantation. We examined current use of intra-aortic balloon pumps (IABPs) before LVAD implantation and compared outcomes of patients with IABP use to those without. We analyzed data from the Interagency Registry for Mechanical Assisted Circulatory Support (INTERMACS) on patients who underwent LVAD implantation between 2006 and 2014. We limited the analysis to patients with an admitting diagnosis of LVAD placement...
March 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29469206/impact-of-sacubitril-valsartan-combination-in-patients-with-chronic-heart-failure-and-sleep-apnoea-syndrome-the-entresto-sas-study-design
#6
Dany Jaffuel, Nicolas Molinari, Philippe Berdague, Atul Pathak, Michel Galinier, Marion Dupuis, Jean-Etienne Ricci, Jean-Pierre Mallet, Arnaud Bourdin, François Roubille
AIMS: Sleep-disordered breathing (SDB) is a highly prevalent co-morbidity in patients with chronic heart failure (CHF) and can play a detrimental role in the pathophysiology course of CHF. However, the best way to manage SDB in CHF remains a matter of debate. Sacubitril-valsartan has been included in the 2016 European Society of Cardiology guidelines as an alternative to angiotensin-converting enzyme inhibitors to further reduce the risk of progression of CHF, CHF hospitalization, and death in ambulatory patients...
February 22, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29469167/increased-mortality-in-patients-with-heart-failure-who-are-taking-commonly-prescribed-antidiabetic-medications-and-achieve-recommended-levels-of-glycemic-control
#7
Milton Packer
Current guidelines for diabetes recommend that physicians attain a glycated hemoglobin (HbA1c) ≤ 7.0%, but this target may not be applicable to those with heart failure. Fourteen studies of patients with chronic heart failure that examined the relationship between the level of glycated hemoglobin and the risk of death specified whether the HbA1c was influenced by treatment with antidiabetic medications. In patients with heart failure not receiving glucose-lowering drugs, mortality was not increased if the HbA1c was <7...
February 22, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29468912/hormone-treatments-in-congestive-heart-failure
#8
Lei Lei, Yuanjie Mao
The common ultimate pathological feature for all cardiovascular diseases, congestive heart failure (CHF), is now considered as one of the main public health burdens that is associated with grave implications. Neurohormonal systems play a critical role in cardiovascular homeostasis, pathophysiology, and cardiovascular diseases. Hormone treatments such as the newly invented dual-acting drug valsartan/sacubitril are promising candidates for CHF, in addition to the conventional medications encompassing beta receptor blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29468706/comparative-cardiovascular-safety-of-non-steroidal-anti-inflammatory-drugs-in-patients-with-hypertension-a-population-based-cohort-study
#9
Yaa-Hui Dong, Chia-Hsuin Chang, Li-Chiu Wu, Jing-Shiang Hwang, Sengwee Toh
AIMS: Prior studies have suggested that non-steroidal anti-inflammatory drugs (NSAIDs) may be associated with higher cardiovascular risks. Few were active-comparison studies that directly assessed potential differential cardiovascular risk between NSAID classes or across individual NSAIDs. We compared the risk of major cardiovascular events between cyclooxygenase-2 enzyme (COX-2) selective NSAIDs and nonselective NSAIDs in patients with hypertension. METHODS: We conducted a cohort study of patients with hypertension who initiated COX-2 selective NSAIDs or nonselective NSAIDs in a population-based Taiwanese database...
February 22, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29468530/the-future-of-biomarker-guided-therapy-for-heart-failure-after-the-guiding-evidence-based-therapy-using-biomarker-intensified-treatment-in-heart-failure-guide-it-study
#10
REVIEW
Nasrien E Ibrahim, James L Januzzi
PURPOSE OF REVIEW: Biomarker-guided management of patients with chronic heart failure with reduced ejection fraction (HFrEF) remains controversial. RECENT FINDINGS: Biomarkers have established roles for diagnosis and prognostication in HF. Pilot data suggested that use of natriuretic peptides might be helpful to guide HF care. The recent Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) randomized-controlled trial did not find therapy guided by NT-proBNP to be more effective than usual care in improving the primary endpoint of HF hospitalization or cardiovascular mortality amongst patients with chronic HFrEF...
February 21, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29468529/right-ventricular-dysfunction-and-its-contribution-to-morbidity-and-mortality-in-left-ventricular-heart-failure
#11
REVIEW
Amresh Raina, Talha Meeran
PURPOSE: In patients with left-sided HF, there has been less emphasis on the pathophysiology of the RV in terms of diagnostic evaluation and treatment, versus focus on structural abnormalities of the LV. This review seeks to delineate the importance of RV dysfunction in terms of its contribution to symptomatic limitations and cardiovascular outcomes in patients with left-sided HF. RECENT FINDINGS: Recent studies have demonstrated that RV dysfunction is common in both HFpEF and HFrEF, but more pronounced in HFrEF...
February 21, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29468383/effect-of-levocarnitine-on-the-therapeutic-efficacy-of-conventional-therapy-in-children-with-dilated-cardiomyopathy-results-of-a-randomized-trial-in-29-children
#12
Yuwen Wang, Yi Xu, Runmei Zou, Lijia Wu, Ping Liu, Hong Yang, Zhenwu Xie, Cheng Wang
BACKGROUND: The effect of levocarnitine supplementation has not been evaluated in children with dilated cardiomyopathy (DCM). OBJECTIVE: The aim of this study was to explore the effect of oral levocarnitine supplementation in pediatric patients with DCM. METHODS: Twenty-nine children with DCM (17 male, 12 female, aged 1 month to 13 years) were divided into two groups according to a simple randomization: control group (n = 10) and experimental group (n = 19)...
February 21, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29467665/analysis-of-microrna-expression-profiles-induced-by-yiqifumai-injection-in-rats-with-chronic-heart-failure
#13
Yu Zhao, Yunfei Li, Ling Tong, Xinying Liang, Han Zhang, Lan Li, Guanwei Fan, Yi Wang
Background: Yiqifumai Injection (YQFM) is clinically used to treat various cardiovascular diseases including chronic heart failure (CHF). The efficacy of YQFM for treating heart failure has been suggested, but the mechanism of action for pharmacological effects of YQFM is unclear. Methods: Echocardiography detection, left ventricular intubation evaluation, histopathology and immunohistochemical examination were performed in CHF rats to evaluate the cardioprotective effect of YQFM. Rat miRNA microarray and bioinformatics analysis were employed to investigate the differentially expressed microRNAs...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29467353/can-tolvaptan-protect-renal-function-in-the-early-postoperative-period-of-cardiac-surgery-results-of-a-single-center-randomized-controlled-study
#14
Yuichiro Kishimoto, Yoshinobu Nakamura, Shingo Harada, Takeshi Onohara, Satoru Kishimoto, Tomohiro Kurashiki, Yoshikazu Fujiwara, Motonobu Nishimura
BACKGROUND: Oral administration of tolvaptan, a vasopressin V2 receptor antagonist, significantly reduces deterioration of renal function, which has recently been highlighted as an exacerbating factor for adverse events in patients with acute heart failure. In the present study we tested the hypothesis that concomitant administration of tolvaptan with a conventional diuretic is beneficial for perioperative body fluid management in patients who have undergone cardiac surgery.Methods and Results:In all, 280 patients who underwent cardiac surgery were prospectively randomized to concomitant treatment with tolvaptan and a conventional diuretic (tolvaptan group; 147 patients) or treatment with a conventional diuretic alone (control group; 133 patients)...
February 21, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29467337/nitric-oxide-sensitive-guanylyl-cyclase-stimulation-improves-experimental-heart-failure-with-preserved-ejection-fraction
#15
Nicola Wilck, Lajos Markó, András Balogh, Kristin Kräker, Florian Herse, Hendrik Bartolomaeus, István A Szijártó, Maik Gollasch, Nadine Reichhart, Olaf Strauss, Arnd Heuser, Damian Brockschnieder, Axel Kretschmer, Ralf Lesche, Florian Sohler, Johannes-Peter Stasch, Peter Sandner, Friedrich C Luft, Dominik N Müller, Ralf Dechend, Nadine Haase
Heart failure with preserved ejection fraction (HFpEF) can arise from cardiac and vascular remodeling processes following long-lasting hypertension. Efficacy of common HF therapeutics is unsatisfactory in HFpEF. Evidence suggests that stimulators of the nitric oxide-sensitive soluble guanylyl cyclase (NOsGC) could be of use here. We aimed to characterize the complex cardiovascular effects of NOsGC stimulation using NO-independent stimulator BAY 41-8543 in a double-transgenic rat (dTGR) model of HFpEF. We show a drastically improved survival rate of treated dTGR...
February 22, 2018: JCI Insight
https://www.readbyqxmd.com/read/29467048/pregnancy-associated-spontaneous-coronary-artery-dissection-pascad-an-etiology-for-chest-pain-in-the-young-peripartum-patient
#16
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
https://www.readbyqxmd.com/read/29467020/insulin-like-growth-factor-1-mediated-regulation-of-mir-193a-expression-promotes-the-migration-and-proliferation-of-c-kit-positive-mouse-cardiac-stem-cells
#17
Yuning Sun, Rongfeng Xu, Jia Huang, Yuyu Yao, Xiaodong Pan, Zhongpu Chen, Genshan Ma
BACKGROUND: C-kit-positive cardiac stem cells (CSCs) have been shown to be a promising candidate treatment for myocardial infarction and heart failure. Insulin-like growth factor (IGF)-1 is an anabolic growth hormone that regulates cellular proliferation, differentiation, senescence, and death in various tissues. Although IGF-1 promotes the migration and proliferation of c-kit-positive mouse CSCs, the underlying mechanism remains unclear. METHODS: Cells were isolated from adult mouse hearts, and c-kit-positive CSCs were separated using magnetic beads...
February 21, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29466689/the-protective-effects-of-gonadotropin-releasing-hormone-agonist-on-ovarian-functions-in-breast-cancer-patients-receiving-chemotherapy
#18
Chen Wang, Xing-Fei Yu
In recent decades, the incidence rate of breast cancer has increased dramatically worldwide and has become one of the most prevalent cancers in women. According to the global data provided by the WHO, there were more than 1.7 million new cases of breast cancer in 2012, accounting for 25% of all reported cancer cases and 15% of all reported deaths among females. To most young patients, especially those younger than 40 years of age, chemotherapy should be taken into consideration as a treatment modality, even if the tumor size is small or without lymphatic metastasis...
January 2018: Discovery Medicine
https://www.readbyqxmd.com/read/29466490/heart-transplantation-for-peripartum-cardiomyopathy-a-single-center-experience
#19
Nadia Bouabdallaoui, Pierre Demondion, Sylvestre Maréchaux, Shaida Varnous, Guillaume Lebreton, Frédéric Mouquet, Pascal Leprince
BACKGROUND: Peripartum cardiomyopathy is an idiopathic disorder defined by the occurrence of acute heart failure during late pregnancy or post-partum period in the absence of any other definable cause. Its clinical course is variable and severe cases might require heart transplantation. OBJECTIVE: To investigate long-term outcomes after heart transplantation (HT) for peripartum cardiomyopathy (PPCM). METHODS: Out of a single-center series of 1938 HT, 14 HT were performed for PPCM...
February 19, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29466489/moderate-continuous-aerobic-exercise-training-improves-cardiomyocyte-contractility-in-%C3%AE-1-adrenergic-receptor-knockout-mice
#20
Aurora Corrêa Rodrigues, Antônio José Natali, Daise Nunes Queiroz da Cunha, Alexandre Jayme Lopes Dantas Costa, Anselmo Gomes de Moura, Miguel Araújo Carneiro-Júnior, Leonardo Bonato Félix, Patrícia Chakur Brum, Thales Nicolau Prímola-Gomes
BACKGROUND: The lack of cardiac β1-adrenergic receptors (β1-AR) negatively affects the regulation of both cardiac inotropy and lusitropy, leading, in the long term, to heart failure (HF). Moderate-intensity aerobic exercise (MCAE) is recommended as an adjunctive therapy for patients with HF. OBJECTIVE: We tested the effects of MCAE on the contractile properties of left ventricular (LV) myocytes from β1 adrenergic receptor knockout (β1ARKO) mice. METHODS: Four- to five-month-old male wild type (WT) and β1ARKO mice were divided into groups: WT control (WTc) and trained (WTt); and β1ARKO control (β1ARKOc) and trained (β1ARKOt)...
February 19, 2018: Arquivos Brasileiros de Cardiologia
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