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https://www.readbyqxmd.com/read/28526593/cardiac-tamponade-as-an-initial-presentation-for-systemic-lupus-erythematosus
#1
William Li, Thomas Frohwein, Kenneth Ong
Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease which follows a relapsing and remitting course that can manifest in any organ system. While classic manifestations consist of arthralgia, myalgia, frank arthritis, a malar rash and renal failure to name a few, cardiac tamponade, however, is a far less common and far more dangerous presentation. We highlight the case of a 61year-old male with complaints of acute onset shortness of breath and generalized body aches associated with a fever and chills in the ER...
April 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28516313/dynamic-changes-in-aortic-impedance-after-transcatheter-aortic-valve-replacement-and-its-impact-on-exploratory-outcome
#2
Yukari Kobayashi, Juyong B Kim, Kegan J Moneghetti, Yuhei Kobayashi, Ran Zhang, Daniel A Brenner, Ryan O'Malley, Ingela Schnittger, Michael Fischbein, D Craig Miller, Alan C Yeung, David Liang, Francois Haddad, William F Fearon
Valvulo-arterial impedance (Zva) has been shown to predict worse outcome in medically managed aortic stenosis (AS) patients. We aimed to investigate the association between Zva and left ventricular (LV) adaptation and to explore the predictive value of Zva for cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR). We prospectively enrolled 128 patients with AS who underwent TAVR. Zva was calculated as: (systolic blood pressure + mean transaortic gradient)/stroke volume index)...
May 17, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28499652/lack-of-furosemide-responsiveness-predicts-acute-kidney-injury-in-infants-after-cardiac-surgery
#3
Aadil Kakajiwala, Ji Young Kim, John Z Hughes, Andrew Costarino, John Ferguson, J William Gaynor, Susan L Furth, Joshua J Blinder
BACKGROUND: This was a retrospective study to determine whether lack of furosemide responsiveness (LFR) predicts acute kidney injury (AKI) after cardiopulmonary bypass surgery in infants. METHODS: Infants (less than 1 year of age) undergoing cardiopulmonary bypass surgery, receiving routine postoperative furosemide (0.8 to 1.2 mg/kg per dose between 8 and 24 hours after surgery) were included. Urine output was measured 2 and 6 hours after furosemide dose. Lack of furosemide responsiveness was defined a priori as urine output less than 1 mL · kg(-1) · h(-1) after furosemide...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28481830/dose-prescription-and-delivery-in-neonates-with-congenital-heart-diseases-treated-with-continuous-veno-venous-hemofiltration
#4
Zaccaria Ricci, Francesco Guzzi, Germana Tuccinardi, Luca Di Chiara, William Clark, Stuart L Goldstein, Claudio Ronco
OBJECTIVES: Renal replacement therapy may be required for acute kidney injury treatment in neonates with complex cardiac conditions. Continuous veno-venous hemofiltration is applied safely in this population but no published recommendations for dose prescription in neonates currently exist. The aim of our study was to evaluate the effects of a relatively small dialysis dose on critically ill neonates. DESIGN: Retrospective analysis of clinical charts. SETTING: Pediatric Cardiac ICU...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#5
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28368043/impact-of-cell-composition-and-geometry-on-human-induced-pluripotent-stem-cells-derived-engineered-cardiac-tissue
#6
Takeichiro Nakane, Hidetoshi Masumoto, Joseph P Tinney, Fangping Yuan, William J Kowalski, Fei Ye, Amanda J LeBlanc, Ryuzo Sakata, Jun K Yamashita, Bradley B Keller
The current study describes a scalable, porous large-format engineered cardiac tissue (LF-ECT) composed of human induced pluripotent stem cells (hiPSCs) derived multiple lineage cardiac cells with varied 3D geometries and cell densities developed towards the goal of scale-up for large animal pre-clinical studies. We explored multiple 15 × 15 mm ECT geometries using molds with rectangular internal staggered posts (mesh, ME), without posts (plain sheet, PS), or long parallel posts (multiple linear bundles, ML) and a gel matrix containing hiPSC-derived cardiomyocytes, endothelial, and vascular mural cells matured in vitro for 14 days...
April 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28344136/prognostic-value-of-soluble-st2-after-myocardial-infarction-a-community-perspective
#7
William S Jenkins, Véronique L Roger, Allan S Jaffe, Susan A Weston, Omar F AbouEzzeddine, Ruoxiang Jiang, Sheila M Manemann, Maurice Enriquez-Sarano
BACKGROUND: Soluble ST2 (sST2) is a marker of cardiac mechanical strain hypothesized to adversely impact short-term prognosis after myocardial infarction. We examined the association of sST2 with longer-term outcomes after myocardial infarction in a geographically defined community. METHODS: Olmsted County, Minnesota residents who experienced an incident (first-ever) myocardial infarction between 11/01/2002 and 12/31/2012 were prospectively enrolled; sST2 levels were measured...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28329173/mitral-valve-repair-for-secondary-mitral-regurgitation-in-non-ischaemic-dilated-cardiomyopathy-is-associated-with-left-ventricular-reverse-remodelling-and-increase-of-forward-flow
#8
Vasileios Kamperidis, Suzanne E van Wijngaarden, Philippe J van Rosendael, William Kok Fai Kong, Madelien V Regeer, Frank van der Kley, Georgios Sianos, Nina Ajmone Marsan, Jeroen J Bax, Victoria Delgado
Aims: It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischaemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. We hypothesized that mitral valve repair improves LV systolic function and forward flow and induces LV reverse remodelling in this group of patients. Methods and results: Seventy-six patients (65 ± 14 years old, 43% male) with non-ischaemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated...
February 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#9
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28238924/postoperative-infections-are-associated-with-increased-risk-of-cardiac-events-in-vascular-patients
#10
Tristen T Chun, Manuel Garcia-Toca, James F Eng, Jeffrey Slaiby, Edward J Marcaccio, William G Cioffi, Daithi S Heffernan
BACKGROUND: Despite advances in perioperative care, the rate of cardiac events in vascular patients remains high. We have previously shown that infections in trauma patients are associated with higher rates of subsequent cardiac complications, likely due to the additive effect of a second hit of an infection following the trauma. The aim of this study was to investigate whether there is an association between postoperative infections and subsequent cardiac events in vascular patients...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28192777/renal-function-and-scaled-troponin-in-patients-presenting-to-the-emergency-department-with-symptoms-of-myocardial-infarction
#11
Anupama Vasudevan, Adam J Singer, Christopher DeFilippi, Gary Headden, Jeffrey M Schussler, Lori B Daniels, Michael Reed, Martin P Than, Robert Birkhahn, Stephen W Smith, Tyler W Barrett, William Arnold, W Frank Peacock, Peter A McCullough
BACKGROUND: Cardiac troponins are often found to be elevated in patients with renal dysfunction, even in the absence of acute myocardial injury. The objective of this report was to characterize the scaled troponin values and proportion of adjudicated acute myocardial infarction (AMI) among patients with and without renal dysfunction. METHODS: The data was from a multicenter prospective study including patients presenting to the emergency department with symptoms of AMI...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28185360/effect-of-environmental-impedance-surrounding-a-radiofrequency-ablation-catheter-electrode-on-lesion-characteristics
#12
Duy T Nguyen, Kianna Nguyen, Lijun Zheng, Joseph Schuller, Matthew Zipse, Wendy S Tzou, William H Sauer
INTRODUCTION: The electrical conductivity of the environment surrounding a catheter electrode may affect radiofrequency (RF) current. A higher impedance environment enveloping a catheter tip can be insulating and thus direct RF preferentially into targeted cardiac tissue. We sought to evaluate whether different environmental impedances will affect RF lesions. METHODS: An ex vivo model using bovine myocardium, load cell, and 4 mm ablation catheter was tested using a circulating bath of normal (0...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28168868/oesophageal-doppler-guided-optimization-of-cardiac-output-does-not-increase-visceral-microvascular-blood-flow-in-healthy-volunteers
#13
Thomas P Heinink, David J Read, William K Mitchell, Ashish Bhalla, Jonathan N Lund, Bethan E Phillips, John P Williams
BACKGROUND: Oesophageal Doppler monitoring (ODM) is used clinically to optimize cardiac output (CO) and guide fluid therapy. Despite limited experimental evidence, it is assumed that increasing CO increases visceral microvascular blood flow (MBF). We used contrast-enhanced ultrasound (CEUS) to assess whether ODM-guided optimization of CO altered MBF. METHODS: Sixteen healthy male volunteers (62 ± 3·4 years) were studied. Baseline measurements of CO were recorded via ODM...
February 6, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28140440/the-effects-of-tibial-intraosseous-versus-intravenous-amiodarone-administration-in-a-hypovolemic-cardiac-arrest-procine-model
#14
Kathryn Hampton, Eric Wang, Jerome Ivan Argame, Tom Bateman, William Craig, Don Johnson
OBJECTIVE: This study compared the effects of amiodarone via tibial intraosseous (TIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, maximum drug concentration (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28056568/in-vitro-metabolite-formation-in-human-hepatocytes-and-cardiomyocytes-and-metabolism-and-tissue-distribution-in-monkeys-of-the-2-c-methylguanosine-prodrug-bms-986094
#15
Wenying Li, Kevin J Trouba, Li Ma, Jae Kwagh, Christopher Storck, Yongxin Zhu, Oliver Flint, William G Humphreys, Jian Wang, Ang Liu, Bonnie Wang, Michael J Graziano, Marc H Davies, Thomas P Sanderson
BMS-986094, a 2'-C-methylguanosine prodrug for the treatment of chronic hepatitis C virus infection, was withdrawn from phase 2 clinical trials because of unexpected cardiac and renal toxicities. To better understand these toxicities, the in vitro metabolism of BMS-986094 in human hepatocytes (HHs) and human cardiomyocytes (HCMs) and the measurement of BMS-986094 and selected metabolites in monkey plasma and tissues were assessed. BMS-986094 was extensively metabolized by HHs and HCMs, resulting in more efficient formation and accumulation of the active triphosphorylated metabolite, INX-09114, and less efficient efflux of metabolites in HCMs...
January 1, 2017: International Journal of Toxicology
https://www.readbyqxmd.com/read/28025189/cardiopoietic-cell-therapy-for-advanced-ischaemic-heart-failure-results-at-39-weeks-of-the-prospective-randomized-double-blind-sham-controlled-chart-1-clinical-trial
#16
Jozef Bartunek, Andre Terzic, Beth A Davison, Gerasimos S Filippatos, Slavica Radovanovic, Branko Beleslin, Bela Merkely, Piotr Musialek, Wojciech Wojakowski, Peter Andreka, Ivan G Horvath, Amos Katz, Dariouch Dolatabadi, Badih El Nakadi, Aleksandra Arandjelovic, Istvan Edes, Petar M Seferovic, Slobodan Obradovic, Marc Vanderheyden, Nikola Jagic, Ivo Petrov, Shaul Atar, Majdi Halabi, Valeri L Gelev, Michael K Shochat, Jaroslaw D Kasprzak, Ricardo Sanz-Ruiz, Guy R Heyndrickx, Noémi Nyolczas, Victor Legrand, Antoine Guédès, Alex Heyse, Tiziano Moccetti, Francisco Fernandez-Aviles, Pilar Jimenez-Quevedo, Antoni Bayes-Genis, Jose Maria Hernandez-Garcia, Flavio Ribichini, Marcin Gruchala, Scott A Waldman, John R Teerlink, Bernard J Gersh, Thomas J Povsic, Timothy D Henry, Marco Metra, Roger J Hajjar, Michal Tendera, Atta Behfar, Bertrand Alexandre, Aymeric Seron, Wendy Gattis Stough, Warren Sherman, Gad Cotter, William Wijns
Aims: Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort. Methods and results: This multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion...
March 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28017384/myocardial-fibrosis-and-cardiac-decompensation-in-aortic-stenosis
#17
Calvin W L Chin, Russell J Everett, Jacek Kwiecinski, Alex T Vesey, Emily Yeung, Gavin Esson, William Jenkins, Maria Koo, Saeed Mirsadraee, Audrey C White, Alan G Japp, Sanjay K Prasad, Scott Semple, David E Newby, Marc R Dweck
OBJECTIVES: Cardiac magnetic resonance (CMR) was used to investigate the extracellular compartment and myocardial fibrosis in patients with aortic stenosis, as well as their association with other measures of left ventricular decompensation and mortality. BACKGROUND: Progressive myocardial fibrosis drives the transition from hypertrophy to heart failure in aortic stenosis. Diffuse fibrosis is associated with extracellular volume expansion that is detectable by T1 mapping, whereas late gadolinium enhancement (LGE) detects replacement fibrosis...
December 8, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27984249/predicting-fluid-responsiveness-in-acute-liver-failure-a-prospective-study
#18
Vinod Kumar Audimoolam, Mark J W McPhail, Chris Willars, William Bernal, Julia A Wendon, Maurizio Cecconi, Georg Auzinger
BACKGROUND: The profound hemodynamic changes seen in acute liver failure (ALF) resemble the hyperdynamic state found in the later stages of septic shock. Vasopressor support frequently is required after initial volume therapy. Markers of preload dependency have not been studied in this patient group. Dynamic maneuvers such as passive leg raising or end-expiratory hold, which have shown good predictive accuracy in a general intensive care unit population, cannot be considered safe in this cohort because of the concerns of intracranial hypertension...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27866925/extracorporeal-membrane-oxygenation-support-and-post-heart-transplant-outcomes-among-united-states-adults
#19
Sandip Zalawadiya, Marat Fudim, Geetha Bhat, William Cotts, JoAnn Lindenfeld
BACKGROUND: Patients supported with extracorporeal membrane oxygenation (ECMO) are given priority listing status for heart transplant (HT). Data on post-HT outcomes for adults with ECMO support at the time of HT are limited. METHODS: We analyzed data from the United Network for Organ Registry (UNOS) registry for 157 ECMO-supported adults (age ≥ 18 years) undergoing HT after January 1, 2000. Data at the time of HT were examined for their association with post-transplant mortality using multivariable Cox proportional hazard analyses...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27779776/a-phase-i-study-to-determine-the-pharmacokinetic-profile-safety-and-tolerability-of-sildenafil-revatio-%C3%A2-in-cardiac-surgery-the-revaki-1-study
#20
Arne Ring, Tom Morris, Marcin Wozniak, Nikol Sullo, William Dott, Veerle Verheyden, Tracy Kumar, Nigel Brunskill, Rakesh Vaja, Gavin J Murphy
AIMS: Acute kidney injury (AKI) is a common and severe complication of cardiac surgery. There is no effective prevention or treatment. Sildenafil citrate (Revatio(®) , Pfizer Inc.), a phosphodiesterase type 5 inhibitor, prevents post cardiac surgery AKI in pre-clinical studies, however its use is contraindicated in patients with symptomatic cardiovascular disease. The aim of this study is to assess the safety and pharmacokinetics of intravenous sildenafil in cardiac surgery patients...
April 2017: British Journal of Clinical Pharmacology
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