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https://www.readbyqxmd.com/read/29678608/clinical-and-hemodynamic-effects-of-intra-aortic-balloon-pump-therapy-in-chronic-heart-failure-patients-with-cardiogenic-shock
#1
Justin A Fried, Abhinav Nair, Koji Takeda, Kevin Clerkin, Veli K Topkara, Amirali Masoumi, Melana Yuzefpolskaya, Hiroo Takayama, Yoshifumi Naka, Daniel Burkhoff, Ajay Kirtane, S M Dimitrios Karmpaliotis, Jeffrey Moses, Paolo C Colombo, A Reshad Garan
BACKGROUND: The role of the intra-aortic balloon pump (IABP) in acute decompensated heart failure (HF) with cardiogenic shock (CS) is largely undefined. In this study we sought to assess the hemodynamic and clinical response to IABP in chronic HF patients with CS and identify predictors of response to this device. METHODS: We retrospectively reviewed all patients undergoing IABP implantation from 2011 to 2016 at our institution to identify chronic HF patients with acute decompensation and CS (cardiac index <2...
March 20, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29677038/postoperative-b-type-natriuretic-peptide-as-predictor-for-postoperative-outcomes-in-patients-implanted-with-left-ventricular-assist-devices
#2
Gardner Yost, Geetha Bhat, Patroklos Pappas, Antone Tatooles
Brain natriuretic peptide (BNP) is a cardiac neurohormone known to correlate with left ventricular (LV) dilation, decreased contractility, and increased stiffness. Consequently, BNP has been used as a prognostic tool to assess the degree of LV unloading for patients supported by continuous-flow LV assist devices (LVADs). We assessed the prognostic value of changes in BNP in the 2 weeks after LVAD implantation. This retrospective study analyzed laboratory findings and outcomes of 189 LVAD patients. Patients were separated into two groups based on whether serum BNP levels had improved from preoperative levels by postoperative day 14...
April 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29676644/air-pollution-exposure-with-fine-dust-responses-in-the-pulmonary-vasculature-and-the-right-heart
#3
Nedim Durmus, Gabriele Grunig
Detrimental effects of air pollution with fine dust (particulate matter ≤2.5 μm in aerodynamic diameter, or PM2.5 ) on the systemic circulation and the left heart have been studied intensely during the past decade. In comparison, knowledge regarding the effects of exposure to air pollution with PM2.5 on the pulmonary vasculature and the right heart lags far behind. A report on severe lung disease and right heart failure in coal miners was published nearly 170 years ago. However, today, we still do not have a clear picture of how the effect of air pollution on the pulmonary circulation or the right heart should be viewed from a clinical, mechanistic biological, therapeutic, or economic angle...
April 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29673504/usefulness-of-tricuspid-annular-diameter-to-predict-late-right-sided-heart-failure-in-patients-with-left-ventricular-assist-device
#4
Koki Nakanishi, Shunichi Homma, Jiho Han, Hiroo Takayama, Paolo C Colombo, Melana Yuzefpolskaya, Arthur R Garan, Maryjane A Farr, Paul Kurlansky, Marco R Di Tullio, Yoshifumi Naka, Koji Takeda
Although late-onset right-sided heart failure is recognized as a clinical problem in the treatment of patients with left ventricular assist devices (LVADs), the mechanism and predictors are unknown. Tricuspid valve (TV) deformation leads to the restriction of the leaflet motion and decreased coaptation, resulting in a functional tricuspid regurgitation that may act as a surrogate marker of late right-sided heart failure. This study aimed to investigate the association of preoperative TV deformation (annulus dilatation and leaflet tethering) with late right-sided heart failure development after continuous-flow LVAD implantation...
March 28, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29670531/beat-to-beat-variability-of-ventricular-action-potential-duration-oscillates-at-low-frequency-during-sympathetic-provocation-in-humans
#5
Bradley Porter, Stefan van Duijvenboden, Martin J Bishop, Michele Orini, Simon Claridge, Justin Gould, Benjamin J Sieniewicz, Baldeep Sidhu, Reza Razavi, Christopher A Rinaldi, Jaswinder S Gill, Peter Taggart
Background: The temporal pattern of ventricular repolarization is of critical importance in arrhythmogenesis. Enhanced beat-to-beat variability (BBV) of ventricular action potential duration (APD) is pro-arrhythmic and is increased during sympathetic provocation. Since sympathetic nerve activity characteristically exhibits burst patterning in the low frequency range, we hypothesized that physiologically enhanced sympathetic activity may not only increase BBV of left ventricular APD but also impose a low frequency oscillation which further increases repolarization instability in humans...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29668926/right-atrial-and-ventricular-echocardiographic-strain-analysis-predicts-requirement-for-right-ventricular-support-after-left-ventricular-assist-device-implantation
#6
Dafni Charisopoulou, Nicholas R Banner, Camil Demetrescu, Andre R Simon, Shelley Rahman Haley
Aims: The need for right ventricular assist device (RVAD) support after left ventricular assist device (LVAD) therapy is associated with increased morbidity and mortality. We used 2D echocardiographic strain analysis to assess right atrial (RA) and right ventricular (RV) mechanics and predict the need for RV mechanical support after LVAD implantation. Methods and results: Seventy advanced chronic heart failure (ACHF) patients [59 male, age 47 ± 12 years, 79% dilated cardiomyopathy, left ventricular ejection fraction 23 ± 10%] received continuous-flow LVAD as a bridge to transplantation over an 18 month period...
April 13, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29663123/creation-of-a-restrictive-atrial-communication-in-heart-failure-with-preserved-and-mid-range-ejection-fraction-effective-palliation-of-left-atrial-hypertension-and-pulmonary-congestion
#7
Anna Bauer, Markus Khalil, Monika Lüdemann, Jürgen Bauer, Anoosh Esmaeili, Roberta De-Rosa, Norbert F Voelkel, Hakan Akintuerk, Dietmar Schranz
BACKGROUND: Left atrial decompression is considered in patients with symptomatic heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the feasibility and efficacy of transcatheter generation of a restrictive atrial septum communication to manage HFpEF from infancy to adulthood with cardiomyopathy and congenital heart defect. METHODS AND RESULTS: From June 2009 to December 2016, 24 patients (50% with an age less than 16 years) with HFpEF were palliated; NYHA-/Ross class IV (n = 10); median systemic ventricular ejection fraction 64 (range 35-78) %...
April 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29660142/use-of-digoxin-in-atrial-fibrillation-one-step-further-in-the-mortality-controversy-from-the-affirm-study
#8
Richard Charnigo, Paul Khairy, Jing Guo, Azadeh Shohoudi, Claude S Elayi
BACKGROUND: Whether there is a causal association between digoxin and mortality among patients with atrial fibrillation (AF), with or without congestive heart failure (HF), has been controversial; in particular, two prior analyses of data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial have yielded conflicting results. We sought to investigate how digoxin impacts mortality, in the full AFFIRM cohort and for various subgroups, by applying marginal structural modeling (MSM) to AFFIRM data...
April 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29658864/right-ventricular-perforation-by-a-defibrillator-lead-migrating-to-the-left-breast
#9
Jerneja Tasic, Rok Zbacnik, Igor Zupan, Jus Ksela
Cardiac perforation after an ICD implantation is a rare complication, with a reported incidence between 0.6-5.2%. Its manifestation might be acute, subacute, or delayed, with an acute perforation occurring within the first 24 hours after implantation, frequently accompanied by severe clinical signs, while subacute and delayed perforations have a more benign progression. Here, we report a case of a 69-year old patient with an acute right ventricular perforation by a defibrillator lead migrating all the way through the pericardium and thoracic wall into the left breast, with an unusually mild and benign clinical course, delaying prompt diagnosis and postponing subsequent surgical treatment...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657594/clinical-and-echocardiographic-response-of-apical-vs-nonapical-right-ventricular-lead-position-in-crt-a-meta-analysis
#10
Sharan Prakash Sharma, Khagendra Dahal, Paari Dominic, Rajbir S Sangha
Background: Traditionally the right ventricular (RV) pacing lead is placed in the RV apex in cardiac resynchronization therapy (CRT). It is not clear whether nonapical placement of the RV lead is associated with a better response to CRT. We aimed to perform a meta-analysis of all randomized controlled trials (RCTs) that compared apical and nonapical RV lead placement in CRT. Methods: We searched PubMed, EMBASE, Cochrane, Scopus, and relevant references for studies and performed meta-analysis using random effects model...
April 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29653363/trapidil-improves-hemodynamic-echocardiographic-and-redox-state-parameters-of-right-ventricle-in-monocrotaline-induced-pulmonary-arterial-hypertension-model
#11
Patrick Türck, Denise Santos Lacerda, Cristina Campos Carraro, Bruna Gazzi de Lima-Seolin, Rayane Brinck Teixeira, Jéssica Hellen Poletto Bonetto, Rafael Colombo, Paulo Cavalheiro Schenkel, Adriane Belló-Klein, Alex Sander da Rosa Araujo
BACKGROUND: Pulmonary arterial hypertension is a disease characterized by increased pulmonary vascular resistance and redox imbalance, leading to failure of right ventricle. Trapidil has been described to improve the redox balance and cardiac conditions. HYPOTHESIS: Trapidil can improve the redox balance and contribute to functional improvements of the RV in PAH. METHODS AND RESULTS: Male, 5week-old Wistar rats were divided into four groups: Control, Control + Trapidil, Monocrotaline and Monocrotaline + Trapidil...
April 10, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29652681/direct-ultrasound-of-the-pulmonary-artery-helps-diagnose-a-rare-cause-of-right-ventricular-failure-after-heart-transplantation-a-case-report
#12
John S McNeil, Si M Pham, Julie L Huffmyer
Pulmonary artery anastomosis stenosis is a rare cause of right ventricular failure after orthotopic heart transplantation. In this case report, direct ultrasound of the pulmonary artery helped diagnose stenosis at a location not visible on transesophageal echocardiography or even with standard epicardial ultrasound views. It is important to evaluate all vascular anastomoses after heart or lung transplantation because surgical revision of these lesions is facile, but if left undiagnosed, significant morbidity or mortality is likely...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29652270/pulmonary-hypertension-and-cardiac-anesthesia-anesthesiologist-s-perspective
#13
REVIEW
Manjula Sudeep Sarkar, Pushkar M Desai
Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#14
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29648700/serial-echocardiographic-changes-with-different-body-positions-and-sleeping-side-preference-in-heart-failure-patients
#15
Muhammed Fatih Bayraktar, Ozcan Ozeke
BACKGROUND: The sleeping position plays an important role in overall health in both healthy individuals and heart failure (HF) patients, which complain of increasing dyspnea when adopting left lateral decubitus position (LLDP) that improves when turning over to the right lateral decubitus position (RLDP). Several theories have been proposed to explain this preference of HF patients; however, the underlying mechanisms remain unclear. METHOD: We evaluated consecutive dilated cardiomyopathy (DCMP) patients with regard to whether they had a sleeping position preference and analyzed early and late left ventricular filling velocities, tissue Doppler recordings, tricuspid annular plane systolic excursion (TAPSE), and left ventricular outflow tract time-velocity integral (LVOT-TVI)...
April 12, 2018: Echocardiography
https://www.readbyqxmd.com/read/29643065/pulmonary-effective-arterial-elastance-as-a-measure-of-right-ventricular-afterload-and-its-prognostic-value-in-pulmonary-hypertension-due-to-left-heart-disease
#16
Emmanouil Tampakakis, Sanjiv J Shah, Barry A Borlaug, Peter J Leary, Harnish H Patel, Wayne L Miller, Benjamin W Kelemen, Brian A Houston, Todd M Kolb, Rachel Damico, Stephen C Mathai, Edward K Kasper, Paul M Hassoun, David A Kass, Ryan J Tedford
BACKGROUND: Patients with combined post- and precapillary pulmonary hypertension due to left heart disease have a worse prognosis compared with isolated postcapillary. However, it remains unclear whether increased mortality in combined post- and precapillary pulmonary hypertension is simply a result of higher total right ventricular load. Pulmonary effective arterial elastance (Ea) is a measure of total right ventricular afterload, reflecting both resistive and pulsatile components. We aimed to test whether pulmonary Ea discriminates survivors from nonsurvivors in patients with pulmonary hypertension due to left heart disease and if it does so better than other hemodynamic parameters associated with combined post- and precapillary pulmonary hypertension...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29642755/successful-treatment-of-ventricular-arrhythmic-storm-with-percutaneous-coronary-intervention-and-catheter-ablation-in-a-patient-with-left-ventricular-assist-device
#17
Nihat Firat Sipahi, Arash Mehdiani, Diyar Saeed, Udo Boeken, Hisaki Makimoto, Artur Lichtenberg, Hannan Dalyanoglu
INTRODUCTION: Ventricular arrhythmias are common in patients with advanced heart failure, which may also persist after sufficient intensive therapy for heart failure even with a left ventricular assist device. Although most ventricular arrhythmias have no hemodynamic relevance during left ventricular assist device support, some patients suffer from right ventricular decompensation due to ventricular arrhythmias resulting in severe hemodynamic deterioration and poor clinical outcomes. METHODS: We describe herein an left ventricular assist device patient with refractory ventricular arrhythmic storm early after left ventricular assist device implantation...
April 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29629994/the-achilles-heel-of-left-ventricular-assist-device-therapy-right-ventricle
#18
Neel K Ranganath, Deane E Smith, Nader Moazami
PURPOSE OF REVIEW: Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29629260/acute-right-ventricular-failure-postintubation-in-a-mitral-stenosis-patient
#19
Sridhar Reddy Musuku, Saroj Pani, John Cagino
Mitral stenosis (MS) is prevalent in 0.02-0.2% of the population in developed countries. The pathophysiology of MS results in elevated left atrial pressures and over-time results in pulmonary hypertension (HTN) which ultimately affects the right ventricle. In addition, MS restricts the diastolic filling of the left ventricle. Therefore, during induction patients with MS are limited by their ability to increase cardiac output by increasing stroke volume. Anesthesia goals in severe MS are to avoid sudden changes in heart rate, as well as systemic and pulmonary artery pressures...
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#20
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
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