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physiology of heart failure

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https://www.readbyqxmd.com/read/29330837/computer-simulated-modeling-of-healthy-and-diseased-right-ventricular-and-pulmonary-circulation
#1
Jody Chou, Joseph B Rinehart
We have previously developed a simulated cardiovascular physiology model for in-silico testing and validation of novel closed-loop controllers. To date, a detailed model of the right heart and pulmonary circulation was not needed, as previous controllers were not intended for use in patients with cardiac or pulmonary pathology. With new development of controllers for vasopressors, and looking forward, for combined vasopressor-fluid controllers, modeling of right-sided and pulmonary pathology is now relevant to further in-silico validation, so we aimed to expand our existing simulation platform to include these elements...
January 12, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29326279/gut-microbiota-in-cardiovascular-disease-and-heart-failure
#2
REVIEW
Takeshi Kitai, W H Wilson Tang
Accumulating evidence supports a relationship between the complexity and diversity of the gut microbiota and host diseases. In addition to alterations in the gut microbial composition, the metabolic potential of gut microbiota has been identified as a contributing factor in the development of diseases. Recent technological developments of molecular and biochemical analyses enable us to detect and characterize the gut microbiota via assessment and classification of its genomes and corresponding metabolites. These advances have provided emerging data supporting the role of gut microbiota in various physiological activities including host metabolism, neurological development, energy homeostasis, and immune regulation...
January 16, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29319170/sirt6-deacetylase-transcriptionally-regulates-glucose-metabolism-in-heart
#3
Danish Khan, Mohsen Sarikhani, Subhajit Dasgupta, Babukrishna Maniyadath, Anwit Shriniwas Pandit, Sneha Mishra, Faiz Ahamed, Abhinav Dubey, Nowrin Fathma, Hanudatta S Atreya, Ullas Kolthur-Seetharam, Nagalingam R Sundaresan
Sirtuins are a family of enzymes, which govern a number of cellular processes essential for maintaining physiological balance. SIRT6, a nuclear localized sirtuin, is implicated in the development of metabolic disorders. The role of SIRT6 in regulation of cardiac metabolism is unexplored. Although glucose is not the primary energy source of heart, defects in glucose oxidation have been linked to heart failure. SIRT6+/- mice hearts exhibit increased inhibitory phosphorylation of PDH subunit E1α. SIRT6 deficiency enhances FoxO1 nuclear localization that results in increased expression of PDK4...
January 10, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29317401/acute-and-chronic-increases-of-circulating-fstl1-normalize-energy-substrate-metabolism-in-pacing-induced-heart-failure
#4
Mitsuru Seki, Jeffery C Powers, Sonomi Maruyama, Maria A Zuriaga, Chia-Ling Wu, Clara Kurishima, Lydia Kim, Jesse Johnson, Anthony Poidomani, Tao Wang, Eric Muñoz, Sudarsan Rajan, Joon Y Park, Kenneth Walsh, Fabio A Recchia
BACKGROUND: FSTL1 (follistatin-like protein 1) is an emerging cardiokine/myokine that is upregulated in heart failure (HF) and is found to be cardioprotective in animal models of cardiac injury. We tested the hypothesis that circulating FSTL1 can affect cardiac function and metabolism under baseline physiological conditions and in HF. METHODS AND RESULTS: FSTL1 was acutely (10 minutes) or chronically (2 weeks) infused to attain clinically relevant blood levels in conscious dogs with cardiac tachypacing-induced HF...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29286270/landmark-lecture-on-cardiac-intensive-care-and-anaesthesia-continuum-and-conundrums
#5
Peter C Laussen
Cardiac anesthesia and critical care provide an important continuum of care for patients with congenital heart disease. Clinicians in both areas work in complex environments in which the interactions between humans and technology is critical. Understanding our contributions to outcomes (modifiable risk) and our ability to perceive and predict an evolving clinical state (low failure-to-predict rate) are important performance metrics. Improved methods for capturing continuous physiologic signals will allow for new and interactive approaches to data visualization, and for sophisticated and iterative data modeling that will help define a patient's phenotype and response to treatment (precision physiology)...
December 2017: Cardiology in the Young
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
#6
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/29276929/-choice-of-angiotensin-receptor-blocker-at-various-stages-of-the-cardiovascular-continuum
#7
V I Podzolkov, N A Dragomiretskaya
We present in this paper modern views on components, physiological and pathophysiological effects of the renin-angiotensin system, pathways of its hyperactivation at various stages of the cardiovascular continuum. Special emphasis is made on angiotensin receptor blockers (sartans). Basing on results of analysis of randomized clinical trials of these agents we have outlined clinical situations in which prescription of one or another drug from this group is preferable. For patients with multiple risk factors of cardiovascular complications preferable agent is telmisartan, for patients with nephropathy - irbesartan, for survivors of acute myocardial infarction - valsartan, while for patients with clinical signs of chronic heart failure with low ejection fraction 3 agents can be designated as preferrable - losartan, valsartan, and candesartan...
October 2017: Kardiologiia
https://www.readbyqxmd.com/read/29275882/dysfunctional-uterine-activity-in-labour-and-premature-adverse-cardiac-events-population-based-cohort-study
#8
Alyssa Kahane, Alison L Park, Joel G Ray
BACKGROUND: There exist structural and physiological commonalities between myometrial and myocardial tissue, and each can become dysfunctional, such as in the presence of cardiometabolic factors. METHODS: This population-based cohort study was comprised of 1,608,720 women with ≥ 1 singleton hospital live birth at 24-41 weeks' gestation in Ontario, from 1992 to 2016. The main exposure was prolonged first stage of labour; secondary exposure was prolonged second stage of labour...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29274474/permanent-his-bundle-pacing-long-term-lead-performance-and-clinical-outcomes
#9
Pugazhendhi Vijayaraman, Angela Naperkowski, Faiz A Subzposh, Mohamed Abdelrahman, Parikshit S Sharma, Jess W Oren, Gopi Dandamudi, Kenneth A Ellenbogen
BACKGROUND: Right ventricular pacing (RVP) is associated with heart failure and increased mortality. His bundle pacing (HBP) is a physiological alternative to RVP. OBJECTIVE: The aim of our study is to report long-term performance and compare the clinical outcomes of permanent HBP to RVP. METHODS: All patients requiring pacemaker implantation underwent attempt at permanent HBP in 2011 at one hospital and RV pacing at the sister hospital. Patients were followed from implantation, 2 weeks, 2 months and yearly for 5 years...
December 20, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29273201/hybrid-palliation-outcomes-after-the-comprehensive-stage-2-procedure
#10
Clifford L Cua, Patrick I McConnell, James M Meza, Kevin D Hill, Shuaiqi Zhang, Diane Hersey, Tara Karamlou, Jeffrey P Jacobs, Marshall L Jacobs, Mark Galantowicz
BACKGROUND: Comprehensive Stage 2 procedure (CS2) follows initial Hybrid Stage 1 palliation for patients with single ventricle physiology. Goal of this study was to describe CS2 outcomes and describe differences between survivors of CS2 (s-CS2) versus non-survivors (nons-CS2). METHODS: All patients in the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) who underwent CS2 as index operation from 2010-2016 were included. Pre-operative, operative, and post-operative data were analyzed, stratified by operative mortality (in-hospital, or within 30 days of surgery), with univariate comparisons using a chi-square / Fisher exact test or Wilcoxon rank sum test...
December 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29259712/pathophysiology-and-therapeutic-potential-of-cardiac-fibrosis
#11
REVIEW
Hironori Hara, Norifumi Takeda, Issei Komuro
Inflammatory and fibrotic responses to myocardial damage are essential for cardiac repair; however, these responses often result in extensive fibrotic remodeling with impaired systolic function. Recent reports have suggested that such acute phase responses provide a favorable environment for endogenous cardiac regeneration, which is mainly driven by the division of pre-existing cardiomyocytes (CMs). Existing CMs in mammals can re-acquire proliferative activity after substantial cardiac damage, and elements other than CMs in the physiological and/or pathological environment, such as hypoxia, angiogenesis, and the polarity of infiltrating macrophages, have been reported to regulate replication...
2017: Inflammation and Regeneration
https://www.readbyqxmd.com/read/29250516/use-of-therapeutic-plasma-exchange-during-extracorporeal-life-support-in-critically-ill-cardiac-children-with-thrombocytopenia-associated-multi-organ-failure
#12
Mei Chong, Alejandro J Lopez-Magallon, Lucas Saenz, Mahesh S Sharma, Andrew D Althouse, Victor O Morell, Ricardo Munoz
Background: Thrombocytopenia-associated multi-organ failure (TAMOF) in children is a well-described factor for increased hospital mortality. Low cardiac output syndrome (LCOS) and the effects of cardiopulmonary bypass may manifest with several adverse physiologic and immunologic effects, with varying degrees of thrombocytopenia and multi-organ dysfunction, sometimes very similar to TAMOF. LCOS is a common occurrence in children with critical heart disease, presenting in as much as 23...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29249470/heart-rate-as-a-prognostic-marker-and-therapeutic-target-in-acute-and-chronic-heart-failure
#13
Fabrizio Oliva, Paola Sormani, Rachele Contri, Carlo Campana, Valentina Carubelli, Antonio Cirò, Fabrizio Morandi, Giuseppe Di Tano, Andrea Mortara, Michele Senni, Marco Metra, Enrico Ammirati
Since increased heart rate (HR) is associated with higher mortality in several cardiac disorders, HR is considered not only a physiological indicator but also a prognostic and biological marker. In heart failure (HF), it represents a therapeutic target in chronic phase. The use or up-titration of beta-blockers, a milestone in HF with reduced left ventricular ejection fraction (LVEF) treatment, is at times limited by patients' hemodynamic profile or intolerance. Ivabradine, a HR-lowering drug inhibiting the f-current in pacemaker cells, has been shown to improve outcome in patients with chronic HF, in sinus rhythm with increased HR beyond beta-blocker therapy...
December 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29249390/left-ventricular-assist-devices-kidney-disease-and-dialysis
#14
Bethany Roehm, Amanda R Vest, Daniel E Weiner
Left ventricular assist devices (LVADs) improve survival in patients with advanced heart failure. As LVAD use increases, so do the number of patients with LVADs who also have kidney disease. However, there are only sparse data on how best to care for these patients. This review provides an overview of LVAD principles and indications, including blood pressure assessment and criteria for receipt of both destination and bridge to transplantation LVADs. Following LVAD implantation, kidney function may improve in the short term, particularly if cardiorenal physiology was present; in the longer term, data remain limited...
December 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29243014/prognostic-value-of-lvedp-in-acute-myocardial-infarction-a-systematic-review-and-meta-analysis
#15
Stephen C Brienesse, Allan J Davies, Arshad Khan, Andrew J Boyle
Left ventricular end-diastolic pressure (LVEDP) is an easily obtained, physiologically integrative measure of total LV function. LVEDP may be a useful prognostic measure in patients with acute myocardial infarction and utilised to guide medical therapy and assess risk for post myocardial infarction heart failure. To assess the utility of LVEDP as a prognostic measure in patients presenting with acute myocardial infarction. We performed an unrestricted search of electronic databases (1946 to March 2017) using a predefined search strategy...
December 14, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29233881/autophagy-in-health-and-disease-focus-on-the-cardiovascular-system
#16
REVIEW
Jeanne Mialet-Perez, Cécile Vindis
Autophagy is a highly conserved mechanism of lysosome-mediated protein and organelle degradation that plays a crucial role in maintaining cellular homeostasis. In the last few years, specific functions for autophagy have been identified in many tissues and organs. In the cardiovascular system, autophagy appears to be essential to heart and vessel homeostasis and function; however defective or excessive autophagy activity seems to contribute to major cardiovascular disorders including heart failure (HF) or atherosclerosis...
December 12, 2017: Essays in Biochemistry
https://www.readbyqxmd.com/read/29227474/a-proteolytic-fragment-of-histone-deacetylase-4-protects-the-heart-from-failure-by-regulating-the-hexosamine-biosynthetic-pathway
#17
Lorenz H Lehmann, Zegeye H Jebessa, Michael M Kreusser, Axel Horsch, Tao He, Mariya Kronlage, Matthias Dewenter, Viviana Sramek, Ulrike Oehl, Jutta Krebs-Haupenthal, Albert H von der Lieth, Andrea Schmidt, Qiang Sun, Julia Ritterhoff, Daniel Finke, Mirko Völkers, Andreas Jungmann, Sven W Sauer, Christian Thiel, Alexander Nickel, Michael Kohlhaas, Michaela Schäfer, Carsten Sticht, Christoph Maack, Norbert Gretz, Michael Wagner, Ali El-Armouche, Lars S Maier, Juan E Camacho Londoño, Benjamin Meder, Marc Freichel, Hermann-Josef Gröne, Patrick Most, Oliver J Müller, Stephan Herzig, Eileen E M Furlong, Hugo A Katus, Johannes Backs
The stress-responsive epigenetic repressor histone deacetylase 4 (HDAC4) regulates cardiac gene expression. Here we show that the levels of an N-terminal proteolytically derived fragment of HDAC4, termed HDAC4-NT, are lower in failing mouse hearts than in healthy control hearts. Virus-mediated transfer of the portion of the Hdac4 gene encoding HDAC4-NT into the mouse myocardium protected the heart from remodeling and failure; this was associated with decreased expression of Nr4a1, which encodes a nuclear orphan receptor, and decreased NR4A1-dependent activation of the hexosamine biosynthetic pathway (HBP)...
December 11, 2017: Nature Medicine
https://www.readbyqxmd.com/read/29226712/-risk-stratification-before-thoracic-surgery-perioperative-pulmonary-rehabilitation
#18
Attila Vágvölgyi, Zsolt Rozgonyi, Pál Vadász, János Tamás Varga
INTRODUCTION: Besides the oncology and operative surgical technics, functional aspects influence the operability of lung cancer. Preoperative risk stratification, evaluation of postoperative complications needs to be considered. AIM: To review international literature and experiences of our institute. METHOD: We focused the literature of risk stratification of thoracic surgery. Lung function, lung mechanics, chest kinematics, exercise physiology were considered...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29221274/predictors-of-high-flow-nasal-cannula-failure-in-immunocompromised-patients-with-acute-respiratory-failure-due-to-non-hiv-pneumocystis-pneumonia
#19
Won-Young Kim, Heungsup Sung, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
Background: To evaluate the predictors of high flow nasal cannula (HFNC) failure in pneumocystis pneumonia (PCP) patients with acute respiratory failure (ARF). Methods: Fifty-two non-HIV-related PCP subjects were divided into a HFNC success group (44%) and a HFNC failure group (who required mechanical ventilation (MV) despite HFNC application) (56%). The clinical characteristics and physiologic effects were retrospectively reviewed and compared between the groups...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29216938/-a-model-based-on-random-forests-in-prediction-of-28-day-prognosis-in-patients-with-severe-sepsis-septic-shock
#20
Yang Wang, Shangzhong Chen, Caibao Hu, Changqin Chen, Jing Yan, Guolong Cai
OBJECTIVE: To establish a severe sepsis/septic shock prognosis prediction model based on randomize forest law (RF model), and to evaluate the prognostic value of this model for patients with severe sepsis/septic shock. METHODS: 497 patients with severe sepsis/septic shock admitted to intensive care unit (ICU) of Zhejiang Hospital from September 2013 to May 2017 were enrolled. The basic data, vital signs and symptoms, biochemical indexes and blood routine indexes on the 1st, 3rd, 5th day and prognosis were collected...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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