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https://www.readbyqxmd.com/read/28646467/symptom-management-challenges-in-heart-failure-pharmacotherapy-considerations
#1
REVIEW
Diana Stewart, Mary Lynn McPherson
Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28645802/comparative-effects-of-long-and-short-acting-loop-diuretics-on-mortality-in-patients-with-chronic-heart-failure
#2
Shu Kasama, Takuji Toyama, Masahiko Kurabayashi
BACKGROUND: We previously reported that the long-acting loop diuretic azosemide improves cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF), compared with short-acting furosemide. However, its influence on mortality has not been determined. METHODS: The present study was a further analysis of our previously published study in which azosemide showed improved (123)I-metaiodobenzylguanidine scintigraphic findings compared with furosemide in CHF patients with reduced left ventricular ejection fraction (LVEF)...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28645757/sympathetic-response-and-outcomes-following-renal-denervation-in-patients-with-chronic-heart-failure-12-month-outcomes-from-the-symplicity-hf-feasibility-study
#3
Ingrid Hopper, Edoardo Gronda, Uta C Hoppe, Bengt Rundqvist, Thomas H Marwick, Sharad Shetty, Christopher Hayward, Thomas Lambert, Dagmara Hering, Murray Esler, Markus Schlaich, Antony Walton, Flavio Airoldi, Mathias-Christoph Brandt, Sidney A Cohen, Pascalle Reiters, Henry Krum
BACKGROUND: Heart failure (HF) is associated with chronic sympathetic activation. Renal denervation (RDN) aims to reduce sympathetic activity by ablating the renal sympathetic nerves. We investigated the effect of RDN in patients with chronic HF and concurrent renal dysfunction, in a prospective, multicenter, single-arm feasibility study. METHODS AND RESULTS: Thirty-nine patients with chronic systolic HF (left ventricular ejection fraction [LVEF] <40%, New York Heart Association class II-III,) and renal impairment (estimated glomerular filtration rate [eGFR; assessed with Modification of Diet in Renal Disease equation] <75 mL/min/1...
June 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28645107/effects-of-liraglutide-on-hemodynamic-parameters-in-patients-with-heart-failure
#4
Jin Ying Zhang, Xin Yun Wang, Xiang Wang
Glucagon-like peptide-1 analogues improve left ventricular function in patients with acute myocardial infarction. This study aimed to evaluate the effects of liraglutide on hemodynamic parameters in patients with heart failure. A total of 78 patients with heart failure were enrolled in this study between August 2014 and November 2015. Of these, 52 patients were randomized 1:1 to receive either liraglutide or placebo for 7 days. Hemodynamic measurements were made using transpulmonary thermodilution and arterial pulse contour analysis...
June 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#5
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643428/mechanical-circulatory-support-in-the-treatment-of-advanced-heart-failure
#6
Amanda W Cai, Sabrina Islam, Shelley R Hankins, Wade Fischer, Howard J Eisen
According to the Centers for Disease Control (CDC), heart failure (HF) remains a pervasive condition with high morbidity and mortality, affecting 5.8 million people in the United States (US) and 23 million worldwide. For patients with refractory end-stage HF, heart transplantation is the gold standard for definitive treatment. However, the demand for heart transplantation has consistently exceeded the availability of donor hearts, with approximately 2,331 orthotopic heart transplantations performed in the US in 2015 despite an estimated 100,000 to 250,000 patients with New York Heart Association (NYHA) class IIIB or IV symptoms that are refractory to medical treatment and potential transplant candidates...
June 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28643218/empagliflozin-improves-left-ventricular-diastolic-dysfunction-in-a-genetic-model-of-type-2-diabetes
#7
Nadjib Hammoudi, Dongtak Jeong, Rajvir Singh, Ahmed Farhat, Michel Komajda, Eric Mayoux, Roger Hajjar, Djamel Lebeche
PURPOSE: Cardiovascular (CV) diseases in type 2 diabetes (T2DM) represent an enormous burden with high mortality and morbidity. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have recently emerged as a new antidiabetic class that improves glucose control, as well as body weight and blood pressure with no increased risk of hypoglycemia. The first CV outcome study terminated with empagliflozin, a specific SGLT2 inhibitor, has shown a reduction in CV mortality and in heart failure hospitalization, suggesting a beneficial impact on cardiac function which remains to be demonstrated...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#8
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#9
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28641794/time-to-furosemide-treatment-and-mortality-in-patients-hospitalized-with-acute-heart-failure
#10
Yuya Matsue, Kevin Damman, Adriaan A Voors, Nobuyuki Kagiyama, Tetsuo Yamaguchi, Shunsuke Kuroda, Takahiro Okumura, Keisuke Kida, Atsushi Mizuno, Shogo Oishi, Yasutaka Inuzuka, Eiichi Akiyama, Ryuichi Matsukawa, Kota Kato, Satoshi Suzuki, Takashi Naruke, Kenji Yoshioka, Tatsuya Miyoshi, Yuichi Baba, Masayoshi Yamamoto, Koji Murai, Kazuo Mizutani, Kazuki Yoshida, Takeshi Kitai
BACKGROUND: Acute heart failure (AHF) is a life-threatening disease requiring urgent treatment, including a recommendation for immediate initiation of loop diuretics. OBJECTIVES: The authors prospectively evaluated the association between time-to-diuretic treatment and clinical outcome. METHODS: REALITY-AHF (Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure) was a prospective, multicenter, observational cohort study that primarily aimed to assess the association between time to loop diuretic treatment and clinical outcome in patients with AHF admitted through the emergency department (ED)...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28641785/acute-detachment-of-hexokinase-ii-from-mitochondria-modestly-increases-oxygen-consumption-of-the-intact-mouse-heart
#11
Rianne Nederlof, Simone Denis, Benjamin Lauzier, Christine Des Rosiers, Markku Laakso, Jacob Hagen, Carmen Argmann, Ronald Wanders, Riekelt H Houtkooper, Markus W Hollmann, Sander M Houten, Coert J Zuurbier
OBJECTIVE: Cardiac hexokinase II (HKII) can translocate between cytosol and mitochondria and change its cellular expression with pathologies such as ischemia-reperfusion, diabetes and heart failure. The cardiac metabolic consequences of these changes are unknown. Here we measured energy substrate utilization in cytosol and mitochondria using stabile isotopes and oxygen consumption of the intact perfused heart for 1) an acute decrease in mitochondrial HKII (mtHKII), and 2) a chronic decrease in total cellular HKII...
July 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28641292/the-incidence-clinical-significance-and-treatment-effects-of-depression-in-cardiac-resynchronization-therapy-recipients
#12
Tomasz Podolecki, Robert Pudlo, Michal Mazurek, Monika Koziel, Ewa Jedrzejczyk-Patej, Joanna Boidol, Katarzyna Przybylska, Adam Sokal, Oskar Kowalski, Jacek Kowalczyk, Radoslaw Lenarczyk, Zbigniew Kalarus
OBJECTIVES: Chronic heart failure (HF) is associated with significantly increased prevalence of depression. The aim of the study was to assess the incidence and clinical impact of depression as well as the effectiveness of depression treatment in HF patients. METHODS: A prospective interventional trial included 285 consecutive cardiac resynchronization therapy recipients. Patients underwent a psychiatric examination at the time of implantation and then it was routinely repeated at 3, 6, and 12 months after the procedure, and every 6 months thereafter...
June 23, 2017: Cardiology
https://www.readbyqxmd.com/read/28640772/the-effect-of-a-carbohydrate-mouth-rinse-on-upper-body-muscular-strength-and-endurance
#13
James E Dunkin, Shaun M Phillips
Dunkin, JE and Phillips, SM. The effect of a carbohydrate mouth rinse on upper-body muscular strength and endurance. J Strength Cond Res 31(7): 1948-1953, 2017-Carbohydrate (CHO) mouth rinsing rapidly increases corticomotor output and maximal muscle force production, which could enhance muscular strength and endurance during resistance exercise. However, previous research has found no effect of CHO rinsing on muscular strength or endurance. The current study altered the CHO rinse composition and frequency and the muscular endurance test to further investigate the effects of a CHO mouth rinse on upper-body muscular strength and endurance...
July 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28639957/pulmonary-arterial-hypertension-induced-by-tyrosine-kinase-inhibitors
#14
Jason Weatherald, Marie-Camille Chaumais, David Montani
PURPOSE OF REVIEW: Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of several neoplastic conditions; however, pulmonary arterial hypertension (PAH) has been reported as a complication of TKIs, predominantly with dasatinib. Recent studies have elucidated the potential mechanisms of TKI-induced PAH and have better clarified the long-term outcomes. RECENT FINDINGS: In addition to the known association between dasatinib and PAH, several other TKIs have recently been reported to cause PAH, including ponatinib, bosutinib and lapatinib...
July 20, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28639841/effects-of-a-mindfulness-based-intervention-on-symptoms-and-signs-in-chronic-heart-failure-a-feasibility-study
#15
Jonna Norman, Michael Fu, Inger Ekman, Lena Björck, Kristin Falk
AIMS: Despite treatment recommended by guidelines, many patients with chronic heart failure remain symptomatic. Evidence is accumulating that mindfulness-based interventions (MBIs) have beneficial psychological and physiological effects. The aim of this study was to explore the feasibility of MBI on symptoms and signs in patients with chronic heart failure in outpatient clinical settings. METHODS: A prospective feasibility study. Fifty stable but symptomatic patients with chronic heart failure, despite optimized guideline-recommended treatment, were enrolled at baseline...
June 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28638891/effect-of-astragaloside-on-vitamin-d-receptor-expression-after-endothelin-1-induced-cardiomyocyte-injury
#16
Chen Yunzhi, Chen Jiaxu, Gao Jie, Chai Yihui, Li Wen, Qin Zhong
BACKGROUND: Astragaloside, which is one of the main components of Astragalus membranaceus, has been widely used in the treatment of congestive heart failure in China, and it can protect cardiomyocytes. Its mechanism of action remains unclear. Therefore, the present study was carried out to investigate the influence of astragaloside on rat cardiomyocytes stimulated with endothelin-1 (ET-1), and explored the underlying mechanism. MATERIALS AND METHODS: ET-1 was used to stimulate primary rat cardiomyocytes and establish a cardiomyocyte hypertrophy model...
2017: African Journal of Traditional, Complementary, and Alternative Medicines: AJTCAM
https://www.readbyqxmd.com/read/28637881/physical-activity-and-prognosis-in-the-treatment-of-preserved-cardiac-function-heart-failure-with-an-aldosterone-antagonist-topcat-trial
#17
Sheila Hegde, Brian Claggett, Amil M Shah, Eldrin F Lewis, Inder S Anand, Sanjiv J Shah, Nancy K Sweitzer, James C Fang, Bertram Pitt, Marc A Pfeffer, Scott D Solomon
Background -Physical activity (PA) is inversely associated with adverse cardiovascular (CV) outcomes in healthy populations but the impact of physical activity in patients with heart failure with preserved ejection fraction (HFpEF) is less well characterized. Methods -The baseline self-reported PA of 1751 subjects enrolled in the Americas region of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial was categorized as poor, intermediate, or ideal PA using American Heart Association (AHA) criteria...
June 21, 2017: Circulation
https://www.readbyqxmd.com/read/28637704/the-structure-function-remodeling-in-rabbit-hearts-of-myocardial-infarction
#18
Haotian Wu, Li Li, Pei Niu, Xu Huang, Jinyi Liu, Fengshun Zhang, Wenzeng Shen, Wenchang Tan, Yiling Wu, Yunlong Huo
Animal models are of importance to investigate basic mechanisms for ischemic heart failure (HF). The objective of the study was to create a rabbit model through multiple coronary artery ligations to investigate the postoperative structure-function remodeling of the left ventricle (LV) and coronary arterial trees. Here, we hypothesize that the interplay of the degenerated coronary vasculature and increased ventricle wall stress relevant to cardiac fibrosis in vicinity of myocardial infarction (MI) precipitates the incidence and progression of ischemic HF Echocardiographic measurements showed an approximately monotonic drop of fractional shortening and ejection fraction from 40% and 73% down to 28% and 58% as well as persistent enlargement of LV cavity and slight mitral regurgitation at postoperative 12 weeks...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28637078/-update-cardiovascular-sleep-medicine
#19
Benedikt Linz, Michael Böhm, Dominik Linz
The prevalence of sleep-disordered breathing (SDB) is high in patients with cardiovascular diseases. Typical symptoms like daytime sleepiness can be absent and those patients may report unspecific, therapy-resistant symptoms related to their underlying disease. Particularly sleep-related symptoms like nocturia, nocturnal dyspnea and pectangina can be present. Based on the results of recently published studies, the treatment of central sleep apnea in patients with symptomatic, systolic heart failure by adaptive servo-ventilation is no longer recommended...
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28636620/risk-of-ischemic-stroke-after-atrial-fibrillation-diagnosis-a-national-sample-cohort
#20
Mi Kyoung Son, Nam-Kyoo Lim, Hyung Woo Kim, Hyun-Young Park
Atrial fibrillation (AF) is a major risk factor for ischemic stroke and associated with a 5-fold higher risk of stroke. In this retrospective cohort study, the incidence of and risk factors for ischemic stroke in patients with AF were identified. All patients (≥30 years old) without previous stroke who were diagnosed with AF in 2007-2013 were selected from the National Health Insurance Service-National Sample Cohort. To identify factors that influenced ischemic stroke risk, Cox proportional hazard regression analysis was conducted...
2017: PloS One
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