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physiology of heart failure

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https://www.readbyqxmd.com/read/28934587/aging-in-the-cardiovascular-system-lessons-from-hutchinson-gilford-progeria-syndrome
#1
Magda R Hamczyk, Lara Del Campo, Vicente Andrés
Aging, the main risk factor for cardiovascular disease (CVD), is becoming progressively more prevalent in our societies. A better understanding of how aging promotes CVD is therefore urgently needed to develop new strategies to reduce disease burden. Atherosclerosis and heart failure contribute significantly to age-associated CVD-related morbimortality. CVD and aging are both accelerated in patients suffering from Hutchinson-Gilford progeria syndrome (HGPS), a rare genetic disorder caused by the prelamin A mutant progerin...
September 20, 2017: Annual Review of Physiology
https://www.readbyqxmd.com/read/28929246/a-numerical-study-of-the-hemodynamic-effect-of-the-aortic-valve-on-coronary-flow
#2
Shaily Wald, Alex Liberzon, Idit Avrahami
During diastole, coronary perfusion depends on the pressure drop between the myocardial tissue and the coronary origin located at the aortic root. This pressure difference is influenced by the flow field near the closing valve leaflets. Clinical evidence is conclusive that patients with severe aortic stenosis (AS) suffer from diastolic dysfunction during hyperemia, but show increased coronary blood flow (CBF) during rest. Transcatheter aortic valve implantation (TAVI) was shown to decrease rest CBF along with its main purpose of improving the aortic flow and reducing the risk of heart failure...
September 19, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28928594/anesthesia-management-of-a-child-with-osteopetrosis
#3
Hashem Jarineshin, Fereydoon Fekrat, Mehdi Feiz Dowlat Abadi
Osteopetrosis is a rare genetic disorder of osteoclast dysfunction leading to anatomical and physiological disorders. We present the anesthesia management for the femur fracture of a 4-year-old girl with malignant infantile type of osteopetrosis. She had a ventriculoperitoneal shunt, impaired motion, visual disturbance, growth failure, facial deformity, heart murmur of moderate tricuspid regurgitation, and left ventricular heart failure, with splenomegaly and severe anemia.
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28925073/role-of-cardiopulmonary-exercise-testing-in-clinical-stratification-in-heart-failure-a-position-paper-from-the-committee-on-exercise-physiology-and-training-of-the-heart-failure-association-of-the-european-society-of-cardiology
#4
REVIEW
Ugo Corrà, Pier Giuseppe Agostoni, Stefan D Anker, Andrew J S Coats, Maria G Crespo Leiro, Rudolph A de Boer, Veli-Pekka Hairola, Loreena Hill, Mitja Lainscak, Lars H Lund, Marco Metra, Piotr Ponikowski, Jillian Riley, Petar M Seferović, Massimo F Piepoli
Traditionally, the main indication for cardiopulmonary exercise testing (CPET) in heart failure (HF) was for the selection of candidates to heart transplantation: CPET was mainly performed in middle-aged male patients with HF and reduced left ventricular ejection fraction. Today, CPET is used in broader patients' populations, including women, elderly, patients with co-morbidities, those with preserved ejection fraction, or left ventricular assistance device recipients, i.e. individuals with different responses to incremental exercise and markedly different prognosis...
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28923305/risk-factors-for-mortality-in-patients-with-low-lactate-level-and-septic-shock
#5
Dong Hyun Oh, Moo Hyun Kim, Woo Yong Jeong, Yong Chan Kim, Eun Jin Kim, Je Eun Song, In Young Jung, Su Jin Jeong, Nam Su Ku, Jun Yong Choi, Young Goo Song, June Myung Kim
BACKGROUND: According to the new definition of septic shock, vasopressor therapy and hyperlactatemia are essential for diagnosis. However, there is controversy regarding the cutoff value for lactate, and prognostic factors in patients with septic shock and hypolactatemia. This study evaluated the prognostic significance of the cutoff value for lactate level in septic shock patients. METHODS: The retrospective observational cohort study enrolled 1043 patients aged ≥18 years who meet the revised definition of septic shock...
August 26, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28921937/ventricular-assist-device-use-in-single-ventricle-congenital-heart-disease
#6
REVIEW
Waldemar F Carlo, Chet R Villa, Ashwin K Lal, David L Morales
As VAD have become an effective therapy for end-stage heart failure, their application in congenital heart disease has increased. Single ventricle congenital heart disease introduces unique physiologic challenges for VAD use. However, with regard to the mixed clinical results presented within this review, we suggest that patient selection, timing of implant, and center experience are all important contributors to outcome. This review focuses on the published experience of VAD use in single ventricle patients and details physiologic challenges and novel approaches in this growing pediatric and adult population...
September 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28915332/obesity-and-cardiometabolic-defects-in-heart-failure-pathology
#7
Ganesh V Halade, Vasundhara Kain
Obesity is a major global epidemic that sets the stage for diverse multiple pathologies, including cardiovascular disease. The obesity-related low-grade chronic inflamed milieu is more pronounced in aging and responsive to cardiac dysfunction in heart failure pathology. Metabolic dysregulation of obesity integrates with immune reservoir in spleen and kidney network. Therefore, an integrative systems biology approach is necessary to delay progressive cardiac alternations. The purpose of this comprehensive review is to largely discuss the impact of obesity on the cardiovascular pathobiology in the context of problems and challenges, with major emphasis on the diversified models, and to study cardiac remodeling in obesity...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28915329/mitophagy-as-a-protective-mechanism-against-myocardial-stress
#8
Jihoon Nah, Shigeki Miyamoto, Junichi Sadoshima
Mitochondria are dynamic organelles that can undergo fusion, fission, biogenesis, and autophagic elimination to maintain mitochondrial quality control. Since the heart is in constant need of high amounts of energy, mitochondria, as a central energy supply source, play a crucial role in maintaining optimal cardiac performance. Therefore, it is reasonable to assume that mitochondrial dysfunction is associated with the pathophysiology of heart diseases. In non-dividing, post-mitotic cells such as cardiomyocytes, elimination of dysfunctional organelles is essential to maintaining cellular function because non-dividing cells cannot dilute dysfunctional organelles through cell division...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#9
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28911177/deoxycorticosterone-salt-mediated-cardiac-inflammation-and-fibrosis-are-dependent-on-functional-clock-signaling-in-male-mice
#10
Elizabeth K Fletcher, James Morgan, David R Kennaway, Laura A Bienvenu, Amanda J Rickard, Lea M D Delbridge, Peter J Fuller, Colin D Clyne, Morag J Young
Activation of the mineralocorticoid receptor (MR) promotes inflammation, fibrosis, and hypertension. Clinical and experimental studies show that MR antagonists have significant therapeutic benefit for all-cause heart failure; however, blockade of renal MRs limits their widespread use. Identification of key downstream signaling mechanisms for the MR in the cardiovascular system may enable development of targeted MR antagonists with selectivity for pathological MR signaling and lower impact on physiological renal electrolyte handling...
September 1, 2017: Endocrinology
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#11
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28905470/outcomes-of-berlin-heart-excor-%C3%A2-pediatric-ventricular-assist-device-support-in-patients-with-restrictive-and-hypertrophic-cardiomyopathy
#12
Jennifer A Su, Jondavid Menteer
The outcomes of pediatric ventricular assist device support in patients with diastolic heart failure have not been well described. This study reviews the North American experience with Berlin Heart EXCOR(®) ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR(®) were identified...
September 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28899987/heart-failure-related-hyperphosphorylation-in-the-cardiac-troponin-i-c-terminus-has-divergent-effects-on-cardiac-function-in-vivo
#13
Yuejin Li, Guangshuo Zhu, Nazareno Paolocci, Pingbo Zhang, Cyrus Takahashi, Nazli Okumus, Amir Heravi, Gizem Keceli, Genaro Ramirez-Correa, David A Kass, Anne M Murphy
BACKGROUND: In human heart failure, Ser199 (equivalent to Ser200 in mouse) of cTnI (cardiac troponin I) is significantly hyperphosphorylated, and in vitro studies suggest that it enhances myofilament calcium sensitivity and alters calpain-mediated cTnI proteolysis. However, how its hyperphosphorylation affects cardiac function in vivo remains unknown. METHODS AND RESULTS: To address the question, 2 transgenic mouse models were generated: a phospho-mimetic cTnIS200D and a phospho-silenced cTnIS200A, each driven by the cardiomyocyte-specific α-myosin heavy chain promoter...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28899782/the-lncrna-gas5-mir-23a-foxo3a-axis-regulates-cardiac-hypertrophy-by-wnt-%C3%AE-catenin-signal-pathway
#14
Wei Wei, Yan Chen, Jing Gao, Chenyi Li
Cardiac hypertrophy (CH) is related to a variety of physiological as well as pathological stimuli and eventually increases the risk of heart failure. lncRNA GAS5 has been identified as a competing endogenous RNA in multiple human biological processes. Whether lncRNA GAS5 is involved in the progress of CH and how it works still remain unknown. Here, we found that the expression of lncRNA-GAS5 was increased in the AngII-induced Cardiac hypertrophy model. lncRNA-GAS5 inhibited the total protein per well, as well as the expression of hypertrophic markers, ANF and β-MHC...
September 9, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28899350/epidemiological-profile-and-obstetric-outcomes-of-patients-with-peripartum-congestive-heart-failure-in-taiwan-a-retrospective-nationwide-study
#15
Ying-Jen Chang, Chung-Han Ho, Jen-Yin Chen, Ming-Ping Wu, Chia-Hung Yu, Jhi-Joung Wang, Chia-Ming Chen, Chin-Chen Chu
BACKGROUND: During pregnancy, the hyperdynamic physiology of circulation can exacerbate many cardiovascular disorders. Congestive heart failure (CHF) usually occurs during late pregnancy, which is significantly associated with a high level of maternal and neonatal morbidities and mortalities. The profile of women who develop peripartum CHF (PCHF) is unknown. We investigated the epidemiological profiles of PCHF. METHODS: In this retrospective cohort study, PCHF patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in Taiwan's National Health Insurance Research Database...
September 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28888522/sleep-disordered-breathing-and-heart-failure-what-does-the-future-hold
#16
REVIEW
Martin R Cowie, Angela M Gallagher
Most patients with heart failure (HF) have sleep-disordered breathing (SDB), with central (rather than obstructive) sleep apnea becoming the predominant form in patients with more severe disease. Cyclical apnea and hypopneas are associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. These patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and can partially normalize the sleep and respiratory physiology...
August 30, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28887766/short-term-effects-of-passive-mobilization-on-the-sublingual-microcirculation-and-on-the-systemic-circulation-in-patients-with-septic-shock
#17
Tuanny Teixeira Pinheiro, Flávio Geraldo Rezende de Freitas, Karla Tuanny Fiorese Coimbra, Vanessa Marques Ferreira Mendez, Heloísa Baccaro Rossetti, Paulo Vinicius Talma, Antônio Tonete Bafi, Flávia Ribeiro Machado
BACKGROUND: Active mobilization is not possible in patients under deep sedation and unable to follow commands. In this scenario, passive therapy is an interesting alternative. However, in patients with septic shock, passive mobilization may have risks related to increased oxygen consumption. Our objective was to evaluate the impact of passive mobilization on sublingual microcirculation and systemic hemodynamics in patients with septic shock. METHODS: We included patients who were older than 18 years, who presented with septic shock, and who were under sedation and mechanical ventilation...
September 8, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28887060/ethnicity-in-pulmonary-arterial-hypertension-possibilities-for-novel-phenotypes-in-the-age-of-personalized-medicine
#18
Sarah K Medrek, Sandeep Sahay
In the last decade and a half, the introduction of new therapeutics has revolutionized the management of pulmonary arterial hypertension (PAH). These new treatment options have improved the quality of life and survival in PAH. With an armamentarium of options available, the identification of unique phenotypes can help practitioners choose tailored treatment regimens. Experts in other cardiovascular diseases such as congestive heart failure and hypertension have recommended race-specific treatments in their fields based on data highlighting variations in response to therapies...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28886170/homoarginine-a-prognostic-indicator-in-adolescents-and-adults-with-complex-congenital-heart-disease
#19
Tanja Raedle-Hurst, Marieke Mueller, Andreas Meinitzer, Winfried Maerz, Thomas Dschietzig
BACKGROUND: Homoarginine (hArg) has been shown to be of prognostic value in patients with chronic left heart failure. The present study aims to assess the clinical utility and prognostic value of hArg levels in patients with complex congenital heart disease (CHD). METHODS: Plasma hArg levels were measured in 143 patients with complex CHD and compared to clinical status, echocardiographic and laboratory parameters as well as the occurrence of adverse cardiac events...
2017: PloS One
https://www.readbyqxmd.com/read/28885986/estimation-of-baroreflex-sensitivity-by-the-bivariate-phase-rectified-signal-averaging-method-a-comparison-with-the-phenylephrine-method
#20
Roberto Maestri, Maria Teresa La Rovere, Grzegorz Raczak, Ludmiła Danilowicz-Szymanowicz, Gian Domenico Pinna
Background A novel technique to assess spontaneous baroreflex sensitivity (BRS) by bivariate phase-rectified signal averaging (PRSA-BRS) has been recently proposed and its independent prognostic power demonstrated. This method, however, has never been compared with the Phenyleprine test (Phe-BRS), commonly regarded as the reference method in clinical and research applications. Methods In 192 heart failure (HF) and 41 post-myocardial infarction (post-MI) patients we compared PRSA-BRS with Phe-BRS, assessing both association and agreement...
September 8, 2017: Physiological Measurement
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