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https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#1
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Nicholaas C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND : Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS : This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29135522/determinants-of-long-term-neurological-recovery-patterns-relative-to-hospital-discharge-among-cardiac-arrest-survivors
#2
Sachin Agarwal, Alex Presciutti, William Roth, Elizabeth Matthews, Ashley Rodriguez, David J Roh, Soojin Park, Jan Claassen, Ronald M Lazar
OBJECTIVE: To explore factors associated with neurological recovery at 1 year relative to hospital discharge after cardiac arrest. DESIGN: Observational, retrospective review of a prospectively collected cohort. SETTING: Medical or surgical ICUs in a single tertiary care center. PATIENTS: Older than 18 years, resuscitated following either in-hospital or out-of-hospital cardiac arrest and considered for targeted temperature management between 2007 and 2013...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29132649/doppler-versus-thermodilution-derived-coronary-microvascular-resistance-to-predict-coronary-microvascular-dysfunction-in-patients-with-acute-myocardial-infarction-or-stable-angina-pectoris
#3
Rupert P Williams, Guus A de Waard, Kalpa De Silva, Matthew Lumley, Kaleab Asrress, Satpal Arri, Howard Ellis, Awais Mir, Brian Clapp, Amedeo Chiribiri, Sven Plein, Paul F Teunissen, Maurits R Hollander, Michael Marber, Simon Redwood, Niels van Royen, Divaka Perera
Coronary microvascular resistance is increasingly measured as a predictor of clinical outcomes, but there is no accepted gold-standard measurement. We compared the diagnostic accuracy of 2 invasive indices of microvascular resistance, Doppler-derived hyperemic microvascular resistance (hMR) and thermodilution-derived index of microcirculatory resistance (IMR), at predicting microvascular dysfunction. A total of 54 patients (61 ± 10 years) who underwent cardiac catheterization for stable coronary artery disease (n = 10) or acute myocardial infarction (n = 44) had simultaneous intracoronary pressure, Doppler flow velocity and thermodilution flow data acquired from 74 unobstructed vessels, at rest and during hyperemia...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29119710/role-of-sdf-1-cxcr4-in-impaired-post-myocardial-infarction-cardiac-repair-in-diabetes
#4
Maritza E Mayorga, Matthew Kiedrowski, Patricia McCallinhart, Farhad Forudi, Jeremiah Ockunzzi, Kristal Weber, William Chilian, Marc S Penn, Feng Dong
Diabetes is a risk factor for worse outcomes following acute myocardial infarction (AMI). In this study, we tested the hypothesis that SDF-1:CXCR4 expression is compromised in post-AMI in diabetes, and that reversal of this defect can reverse the adverse effects of diabetes. Mesenchymal stem cells (MSC) isolated from green fluorescent protein (GFP) transgenic mice (control MSC) were induced to overexpress stromal cell-derived factor-1 (SDF-1). SDF-1 expression in control MSC and SDF-1-overexpressing MSC (SDF-1:MSC) were quantified using enzyme-linked immunosorbent assay (ELISA)...
November 9, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29100062/thoracic-extra-coronary-calcification-for-the-prediction-of-stroke-the%C3%A2-multi-ethnic-study-of-atherosclerosis
#5
Sina Kianoush, Mahmoud Al Rifai, Miguel Cainzos-Achirica, Mouaz H Al-Mallah, Geoffrey H Tison, Joseph Yeboah, Michael D Miedema, Matthew A Allison, Nathan D Wong, Andrew P DeFilippis, William Longstreth, Khurram Nasir, Matthew J Budoff, Kunihiro Matsushita, Michael J Blaha
BACKGROUND AND AIMS: Atherosclerosis is a systemic disease. We examined whether the cumulative burden of thoracic extra-coronary calcification (ECC) improves prediction of stroke, transient ischemic attack (TIA), and stroke mortality beyond traditional risk factors and coronary artery calcium (CAC). METHODS: We followed a total of 6805 participants (mean age 62.1 ± 10.2 years, 47.2% male) from the Multi-Ethnic Study of Atherosclerosis (MESA) over a median of 12...
October 7, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29073228/using-a-whole-body-31p-birdcage-transmit-coil-and-16-element-receive-array-for-human-cardiac-metabolic-imaging-at-7t
#6
Ladislav Valkovič, Iulius Dragonu, Salam Almujayyaz, Alex Batzakis, Liam A J Young, Lucian A B Purvis, William T Clarke, Tobias Wichmann, Titus Lanz, Stefan Neubauer, Matthew D Robson, Dennis W J Klomp, Christopher T Rodgers
PURPOSE: Cardiac phosphorus magnetic resonance spectroscopy (31P-MRS) provides unique insight into the mechanisms of heart failure. Yet, clinical applications have been hindered by the restricted sensitivity of the surface radiofrequency-coils normally used. These permit the analysis of spectra only from the interventricular septum, or large volumes of myocardium, which may not be meaningful in focal disease. Löring et al. recently presented a prototype whole-body (52 cm diameter) transmit/receive birdcage coil for 31P at 7T...
2017: PloS One
https://www.readbyqxmd.com/read/29046319/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-the-pacify-randomized-clinical-trial
#7
John W McEvoy, Khalil Ibrahim, Thomas S Kickler, William A Clarke, Rani K Hasan, Matthew J Czarny, Ali R Keramati, Rakesh R Goli, Travis P Gratton, Jeffrey A Brinker, Matthews Chacko, Chao-Wei Hwang, Peter V Johnston, Julie M Miller, Jeffrey C Trost, William R Herzog, Roger S Blumenthal, David R Thiemann, Jon R Resar, Steven P Schulman
Fentanyl is a potent opiate commonly administered during cardiac catheterization procedures in North America. The question of whether fentanyl could have adverse consequences in patients undergoing percutaneous coronary intervention (PCI) is raised by recent research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The presumed mechanism is slowed gastric emptying. The single-center Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial randomized adults undergoing clinically-indicated elective coronary angiography to receive the procedure with or without intravenous fentanyl (NCT02683707)...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29040414/luma-is-not-essential-for-murine-cardiac-development-and-function
#8
Matthew John Stroud, Xi Fang, Jianlin Zhang, Nuno Guimarães-Camboa, Jennifer Veevers, Nancy D Dalton, Yusu Gu, William H Bradford, Kirk L Peterson, Sylvia M Evans, Larry Gerace, Ju Chen
Aims: Luma is a recently discovered, evolutionarily conserved protein expressed in mammalian heart that is associated with the LInker of Nucleoskeleton and Cytoskeleton (LINC) complex. The LINC complex structurally integrates the nucleus and the cytoplasm, and plays a critical role in mechanotransduction across the nuclear envelope. Mutations in several LINC components in both humans and mice result in various cardiomyopathies, implying they play essential, non-redundant roles. A single amino acid substitution of serine 358 to leucine (S358L) in LUMA is the unequivocal cause of a distinct form of arrhythmogenic cardiomyopathy...
October 12, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29024245/hace1-influences-zebrafish-cardiac-development-via-ros-dependent-mechanisms
#9
Babak Razaghi, Shelby L Steele, Sergey V Prykhozhij, Matthew R Stoyek, Jessica A Hill, Matthew D Cooper, Lindsay Mcdonald, William Lin, Mads Daugaard, Nicolas Crapoulet, Simi Chacko, Stephen M Lewis, Ian C Scott, Poul H B Sorensen, Jason N Berman
BACKGROUND: In this study, we reveal a previously undescribed role of the HACE1 (HECT domain and Ankyrin repeat Containing E3 ubiquitin-protein ligase 1) tumor suppressor protein in normal vertebrate heart development using the zebrafish (Danio rerio) model. We examined the link between the cardiac phenotypes associated with hace1 loss of function to the expression of the Rho small family GTPase, rac1, which is a known target of HACE1 and promotes ROS production via its interaction with NADPH oxidase holoenzymes...
October 11, 2017: Developmental Dynamics: An Official Publication of the American Association of Anatomists
https://www.readbyqxmd.com/read/29021267/association-of-neighborhood-socioeconomic-context-with-participation-in-cardiac-rehabilitation
#10
Justin M Bachmann, Shi Huang, Deepak K Gupta, Loren Lipworth, Michael T Mumma, William J Blot, Elvis A Akwo, Sunil Kripalani, Mary A Whooley, Thomas J Wang, Matthew S Freiberg
BACKGROUND: Cardiac rehabilitation (CR) is underutilized in the United States, with fewer than 20% of eligible patients participating in CR programs. Individual socioeconomic status is associated with CR utilization, but data regarding neighborhood characteristics and CR are sparse. We investigated the association of neighborhood socioeconomic context with CR participation in the SCCS (Southern Community Cohort Study). METHODS AND RESULTS: The SCCS is a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28972674/quantifying-rapid-changes-in-cardiovascular-state-with-a-moving-ensemble-average
#11
Matthew Cieslak, William S Ryan, Viktoriya Babenko, Hannah Erro, Zoe M Rathbun, Wendy Meiring, Robert M Kelsey, Jim Blascovich, Scott T Grafton
MEAP, the moving ensemble analysis pipeline, is a new open-source tool designed to perform multisubject preprocessing and analysis of cardiovascular data, including electrocardiogram (ECG), impedance cardiogram (ICG), and continuous blood pressure (BP). In addition to traditional ensemble averaging, MEAP implements a moving ensemble averaging method that allows for the continuous estimation of indices related to cardiovascular state, including cardiac output, preejection period, heart rate variability, and total peripheral resistance, among others...
October 3, 2017: Psychophysiology
https://www.readbyqxmd.com/read/28925929/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report
#12
Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie
OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28920097/acute-cd47-blockade-during-ischemic-myocardial-reperfusion-enhances-phagocytosis-associated-cardiac-repair
#13
Shuang Zhang, Xin-Yi Yeap, Matthew DeBerge, Nivedita K Naresh, Kevin Wang, Zhengxin Jiang, Jane E Wilcox, Steven M White, John P Morrow, Paul W Burridge, Daniel Procissi, Evan A Scott, William Frazier, Edward B Thorp
Our data suggest that, after a myocardial infarction, integrin-associated protein CD47 on cardiac myocytes is elevated. In culture, increased CD47 on the surface of dying cardiomyocytes impairs phagocytic removal by immune cell macrophages. After myocardial ischemia and reperfusion, acute CD47 inhibition with blocking antibodies enhanced dead myocyte clearance by cardiac phagocytes and also improved the resolution of cardiac inflammation, reduced infarct size, and preserved cardiac contractile function. Early targeting of CD47 in the myocardium after reperfusion may be a new strategy to enhance wound repair in the ischemic heart...
August 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28859401/do-bar-headed-geese-train-for-high-altitude-flights
#14
Lucy A Hawkes, Nyambayar Batbayar, Patrick J Butler, Beverley Chua, Peter B Frappell, Jessica U Meir, William K Milsom, Tseveenmyadag Natsagdorj, Nicole Parr, Graham R Scott, John Y Takekawa, Martin WikeIski, Matthew J Witt, Charles M Bishop
Exercise at high altitude is extremely challenging, largely due to hypobaric hypoxia (low oxygen levels brought about by low air pressure). In humans, the maximal rate of oxygen consumption decreases with increasing altitude, supporting progressively poorer performance. Bar-headed geese (Anser indicus) are renowned high altitude migrants and, although they appear to minimize altitude during migration where possible, they must fly over the Tibetan Plateau (mean altitude 4800 m) for much of their annual migration...
August 1, 2017: Integrative and Comparative Biology
https://www.readbyqxmd.com/read/28851810/mertk-cleavage-on-resident-cardiac-macrophages-compromises-repair-after-myocardial-ischemia-reperfusion-injury
#15
Matthew DeBerge, Xin Yi Yeap, Shirley Dehn, Shuang Zhang, Lubov Grigoryeva, Sol Misener, Daniel Procissi, Xin Zhou, Daniel C Lee, William A Muller, Xunrong Luo, Carla Rothlin, Ira Tabas, Edward B Thorp
RATIONALE: Clinical benefits of reperfusion after myocardial infarction are offset by maladaptive innate immune cell function, and therapeutic interventions are lacking. OBJECTIVE: We sought to test the significance of phagocytic clearance by resident and recruited phagocytes after myocardial ischemia reperfusion. METHODS AND RESULTS: In humans, we discovered that clinical reperfusion after myocardial infarction led to significant elevation of the soluble form of MerTK (myeloid-epithelial-reproductive tyrosine kinase; ie, soluble MER), a critical biomarker of compromised phagocytosis by innate macrophages...
September 29, 2017: Circulation Research
https://www.readbyqxmd.com/read/28843411/the-activin-receptor-is-stimulated-in-the-skeleton-vasculature-heart-and-kidney-during-chronic-kidney-disease
#16
Matthew J Williams, Toshifumi Sugatani, Olga A Agapova, Yifu Fang, Joseph P Gaut, Marie-Claude Faugere, Hartmut H Malluche, Keith A Hruska
We examined activin receptor type IIA (ActRIIA) activation in chronic kidney disease (CKD) by signal analysis and inhibition in mice with Alport syndrome using the ActRIIA ligand trap RAP-011 initiated in 75-day-old Alport mice. At 200 days of age, there was severe CKD and associated Mineral and Bone Disorder (CKD-MBD), consisting of osteodystrophy, vascular calcification, cardiac hypertrophy, hyperphosphatemia, hyperparathyroidism, elevated FGF23, and reduced klotho. The CKD-induced bone resorption and osteoblast dysfunction was reversed, and bone formation was increased by RAP-011...
August 23, 2017: Kidney International
https://www.readbyqxmd.com/read/28807212/comparison-of-normothermic-and-hypothermic-perfusion-in-porcine-kidneys-donated-after-cardiac-death
#17
COMPARATIVE STUDY
Matthew F Blum, Qiang Liu, Basem Soliman, Paul Dreher, Toshihiro Okamoto, Emilio D Poggio, David A Goldfarb, William M Baldwin, Cristiano Quintini
BACKGROUND: Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. METHODS: Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28802637/blood-pressure-responses-to-dietary-sodium-association-with-autonomic-cardiovascular-function-in-normotensive-adults
#18
Evan L Matthews, Michael S Brian, David G Edwards, Sean D Stocker, Megan M Wenner, William B Farquhar
Blood pressure responses to dietary sodium vary widely person-to-person. Salt sensitive rodent models display altered autonomic function, a trait thought to contribute to poor cardiovascular health. Thus, we hypothesized that increased salt sensitivity (SS) in normotensive humans would be associated with increased muscle sympathetic nerve activity (MSNA), decreased high frequency heart rate variability (HF-HRV), and decreased baroreflex sensitivity. Healthy normotensive men and women completed 1week of high (300mmol·day(-1)) and 1week of low (20mmol·day(-1)) dietary sodium (random order) with 24h mean arterial pressure (MAP) assessed on the last day of each diet to assess SS...
August 6, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28798025/novel-genetic-triggers-and-genotype-phenotype-correlations-in-patients-with-left-ventricular-noncompaction
#19
Karol Miszalski-Jamka, John L Jefferies, Wojciech Mazur, Jan Głowacki, Jianhong Hu, Monika Lazar, Richard A Gibbs, Jacek Liczko, Jan Kłyś, Eric Venner, Donna M Muzny, Jarosław Rycaj, Jacek Białkowski, Ewa Kluczewska, Zbigniew Kalarus, Shalini Jhangiani, Hussein Al-Khalidi, Tomasz Kukulski, James R Lupski, William J Craigen, Matthew N Bainbridge
BACKGROUND: Left ventricular noncompaction (LVNC) is a genetically and phenotypically heterogeneous disease and, although increasingly recognized in clinical practice, there is a lack of widely accepted diagnostic criteria. We sought to identify novel genetic causes of LVNC and describe genotype-phenotype correlations. METHODS AND RESULTS: A total of 190 patients from 174 families with left ventricular hypertrabeculation (LVHT) or LVNC were referred for cardiac magnetic resonance and whole-exome sequencing...
August 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28678071/reporting-of-perioperative-adverse-events-by-pediatric-anesthesiologists-at-a-tertiary-children-s-hospital-targeted-interventions-to-increase-the-rate-of-reporting
#20
Glyn D Williams, Matthew K Muffly, Julianne M Mendoza, Nina Wixson, Kit Leong, Rebecca E Claure
BACKGROUND: Incident reporting systems (IRSs) are important patient safety tools for identifying risks and opportunities for improvement. A major IRS limitation is underreporting of incidents. Perioperative anesthesia IRSs have been established at multiple pediatric institutions and a national pediatric anesthesia IRS for perioperative serious adverse events (SAEs) is maintained by Wake Up Safe (WUS), a patient safety organization dedicated to pediatric anesthesia quality improvement...
November 2017: Anesthesia and Analgesia
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