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Acute heart failure in adults

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https://www.readbyqxmd.com/read/28315072/direct-myosin-activation-by-omecamtiv-mecarbil-for-heart-failure-with-reduced-ejection-fraction
#1
Mitchell A Psotka, John R Teerlink
Myosin is the indispensable molecular motor that utilizes chemical energy to produce force for contraction within the cardiac myocyte. Myosin activity is gated by intracellular calcium levels which are regulated by multiple upstream signaling cascades that can be altered for clinical utility using inotropic medications. In contrast to clinically available cardiac inotropes, omecamtiv mecarbil is a novel direct myosin activator developed to augment left ventricular systolic function without the undesirable secondary effects of altered calcium homeostasis...
March 18, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#2
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes. SETTING: Tertiary care academic center...
March 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#3
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28283007/-mortality-related-factors-in-patients-requiring-hospitalization-for-influenza-like-illness
#4
Lale Özışık, Mine Durusu Tanrıöver, Meral Çıblak Akçay, Kübra Yuntçu, Serhat Ünal, Selim Badur, Banu Çakır
The knowledge about the viral etiologies causing respiratory disease in adults is limited. Viral respiratory diseases may lead deterioration in certain patient populations. The aim of this study was to determine the viral etiologies of influenza-like illness among patients requiring hospitalization and to document the risk factors for mortality. This prospective study was performed in one of the 7 centers in Turkey in the context of influenza surveillance by the Global Influenza Hospital Surveillance Network...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28262349/trends-in-heart-failure-hospitalizations-patient-characteristics-in-hospital-and-1-year-mortality-a-population-study-from-2000-to-2012-in-lombardy
#5
Maria Frigerio, Cristina Mazzali, Anna Maria Paganoni, Francesca Ieva, Pietro Barbieri, Mauro Maistrello, Ornella Agostoni, Cristina Masella, Simonetta Scalvini
BACKGROUND: This study was undertaken to evaluate trends in heat failure hospitalizations (HFHs) and 1-year mortality of HFH in Lombardy, the largest Italian region, from 2000 to 2012. METHODS: Hospital discharge forms with HF-related ICD-9 CM codes collected from 2000 to 2012 by the regional healthcare service (n=699797 in 370538 adult patients), were analyzed with respect to in-hospital and 1-year mortality; Group (G) 1 included most acute HF episodes with primary cardiac diagnosis (70%); G2 included cardiomyopathies without acute HF codes (17%); and G3 included non-cardiac conditions with HF as secondary diagnosis (13%)...
February 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28262267/frequency-of-early-predialysis-nephrology-care-and%C3%A2-postdialysis%C3%A2-cardiovascular-events
#6
Ju-Yeh Yang, Jenq-Wen Huang, Likwang Chen, Yun-Yi Chen, Mei-Fen Pai, Kuei-Ting Tung, Yu-Sen Peng, Kuan-Yu Hung
BACKGROUND: Patients with kidney failure are at a high risk for cardiovascular events. Predialysis nephrology care has been reported to improve postdialysis survival, but its effects on postdialysis major adverse cardiovascular events (MACEs) have not been comprehensively studied. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: We used data from the National Health Insurance Research Database in Taiwan. Adult patients who initiated maintenance dialysis therapy in 1999 to 2010 were enrolled...
March 2, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28262214/hospital-management-of-acute-decompensated-heart-failure
#7
REVIEW
Ashraf S Abdo
Heart failure (HF) is one of the leading causes of hospitalizations for elderly adults in the United States. One in 5 Americans will be >65 years of age by 2050. Because of the high prevalence of HF in this group, the number of Americans requiring hospitalization for this disorder is expected to rise significantly. We reviewed the most recent and ongoing studies and recommendations for the management of patients hospitalized due to decompensated HF. The Acute Decompensated Heart Failure National Registry, together with the 2013 American College of Cardiology Foundation and American Heart Association heart failure guidelines, earlier retrospective and prospective studies including the Diuretic Optimization Strategies Evaluation (DOSE), the Trial of Intensified vs Standard Medical Therapy in the Elderly Patients With Congestive Heart Failure (TIME-CHF), the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF), the Rapid Emergency Department Heart Failure Outpatient Trial (REDHOT) and the Comparison of Medical, Pacing and Defibrillation Therapies in Heart Failure (COMPANION) trial were reviewed for current practices pertaining to these patients...
March 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28248808/continuous-intravenous-milrinone-therapy-in-pediatric-outpatients
#8
Michelle Curley, Jill Liebers, Roy Maynard
Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy...
March 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28248798/evaluation-of-the-relationship-between-serum-uric-acid-levels-and-cardiovascular-events-in-patients-with-gout-a-retrospective-analysis-using-electronic-medical-record-data
#9
Margaret Noyes Essex, Markay Hopps, E Jay Bienen, Margarita Udall, Jack Mardekian, Geoffrey T Makinson
OBJECTIVES: The aim of this study was to evaluate relationships between serum uric acid (SUA) and newly emergent acute myocardial infarction (AMI), congestive heart failure (CHF), coronary artery disease (CAD), composite cardiovascular (CV) events (AMI, CHF, CAD), hypertension, hyperlipidemia, and renal disease in gout patients. METHODS: Retrospective analysis of electronic medical records from Humedica identified adults (≥18 years) with 2 or more International Classification of Diseases, Ninth Revision, Clinical Modification codes for gout 30 days or more apart (first diagnosis = index event) having 1 or more SUA assessment on or after the index date, and at least 6 months preindex and at least 12 months postindex enrollment...
February 28, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28239661/klf2-and-klf4-control-endothelial-identity-and-vascular-integrity
#10
Panjamaporn Sangwung, Guangjin Zhou, Lalitha Nayak, E Ricky Chan, Sandeep Kumar, Dong-Won Kang, Rongli Zhang, Xudong Liao, Yuan Lu, Keiki Sugi, Hisashi Fujioka, Hong Shi, Stephanie D Lapping, Chandra C Ghosh, Sarah J Higgins, Samir M Parikh, Hanjoong Jo, Mukesh K Jain
Maintenance of vascular integrity in the adult animal is needed for survival, and it is critically dependent on the endothelial lining, which controls barrier function, blood fluidity, and flow dynamics. However, nodal regulators that coordinate endothelial identity and function in the adult animal remain poorly characterized. Here, we show that endothelial KLF2 and KLF4 control a large segment of the endothelial transcriptome, thereby affecting virtually all key endothelial functions. Inducible endothelial-specific deletion of Klf2 and/or Klf4 reveals that a single allele of either gene is sufficient for survival, but absence of both (EC-DKO) results in acute death from myocardial infarction, heart failure, and stroke...
February 23, 2017: JCI Insight
https://www.readbyqxmd.com/read/28230811/basigin-rs8259-polymorphism-confers-decreased-risk-of-chronic-heart-failure-in-a-chinese-population
#11
Mu-Peng Li, Xiao-Lei Hu, Yong-Long Yang, Yan-Jiao Zhang, Ji-Peng Zhou, Li-Ming Peng, Jie Tang, Xiao-Ping Chen
Left ventricular remodeling is an essential risk factor contributing to the pathogenesis of chronic heart failure (CHF). Basigin (BSG) promotes cardiovascular inflammation and myocardial remodeling processes by induction of extracellular matrix metalloproteinases and inflammatory cytokines. BSG rs8259 polymorphism was associated with BSG expression and risk of acute coronary syndrome. Therefore, we investigated whether rs8259 polymorphism contributes to risk and prognosis of CHF in Chinese patients. In total 922 adult patients with CHF and 1107 matched healthy controls were enrolled...
February 21, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28221206/significance-of-new-q-waves-and-their-location-in-postoperative-ecgs-after-elective-on-pump-cardiac-surgery-an-observational-cohort-study
#12
Eckhard Mauermann, Daniel Bolliger, Jens Fassl, Martin Grapow, Esther E Seeberger, Manfred D Seeberger, Miodrag Filipovic, Giovanna A L L Buse
BACKGROUND: The clinical significance of new pathological Q waves after on-pump cardiac surgery is uncertain. OBJECTIVES: To determine whether or not either the occurrence per se or the location of new pathological Q waves after on-pump cardiac surgery is associated with 12-month, all-cause mortality and/or major adverse cardiac events (MACEs). DESIGN: Observational cohort study. SETTING: Single university hospital from January 2007 to October 2010...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28219188/-change-of-prognosis-and-pathogens-in-adult-patients-with-severe-community-acquired-pneumonia-during-different-periods
#13
L Zhang, P Ning, F Rong, Z C Gao
Objective: To compare the change of prognosis and pathogens of adult patients with severe community-acquired pneumonia (CAP) requiring admission to Respiratory Intensive Care Unit (RICU) during different period, and estimate the risk factors of severe CAP. Methods: The clinical data of 186 patients with severe CAP admission to RICU was collected and assessed the trend in outcomes of these patients during three time periods: Period Ⅰ (January 1 2000 to October 31 2006), Period Ⅱ (November 1 2006 to December 31 2010), and Period Ⅲ (January 1 2011 to December 31 2015), analyzed the risk factors by Cox Proportional Hazards regression, and compared the pathogens detection...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#14
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#15
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28202059/cardiosphere-derived-cells-do-not-improve-cardiac-function-in-rats-with-cardiac-failure
#16
Taís Hanae Kasai-Brunswick, Andréa Rodrigues da Costa, Raiana Andrade Quintanilha Barbosa, Bruna Farjun, Fernanda Cristina Paccola Mesquita, Danúbia Silva Dos Santos, Isalira Peroba Ramos, Grazielle Suhett, Guilherme Visconde Brasil, Sandro Torrentes da Cunha, José Oscar R Brito, Juliana do Amaral Passipieri, Adriana Bastos Carvalho, Antonio Carlos Campos de Carvalho
BACKGROUND: Heart failure represents an important public health issue due to its high costs and growing incidence worldwide. Evidence showing the regenerative potential of postmitotic heart tissue has suggested the existence of endogenous cardiac stem cells in adult hearts. Cardiosphere-derived cells (CDC) constitute a candidate pool of such cardiac stem cells. Previous studies using acute myocardial infarction (MI) models in rodents demonstrated an improvement in cardiac function after cell therapy with CDC...
February 15, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28196265/association-of-coronary-artery-calcium-in-adults-aged-32-to-46-years-with-incident-coronary-heart-disease-and-death
#17
John Jeffrey Carr, David R Jacobs, James G Terry, Christina M Shay, Stephen Sidney, Kiang Liu, Pamela J Schreiner, Cora E Lewis, James M Shikany, Jared P Reis, David C Goff
Importance: Coronary artery calcium (CAC) is associated with coronary heart disease (CHD) and cardiovascular disease (CVD); however, prognostic data on CAC are limited in younger adults. Objective: To determine if CAC in adults aged 32 to 46 years is associated with incident clinical CHD, CVD, and all-cause mortality during 12.5 years of follow-up. Design, Setting, and Participants: The Coronary Artery Risk Development in Young Adults (CARDIA) Study is a prospective community-based study that recruited 5115 black and white participants aged 18 to 30 years from March 25, 1985, to June 7, 1986...
February 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28193605/potential-deaths-averted-and-serious-adverse-events-incurred-from-adoption-of-the-sprint-intensive-blood-pressure-regimen-in-the-u-s-projections-from-nhanes
#18
Adam P Bress, Holly Kramer, Rasha Khatib, Srinivasan Beddhu, Alfred K Cheung, Rachel Hess, Vinod K Bansal, Guichan Cao, Jerry Yee, Andrew E Moran, Ramon A Durazo-Arvizu, Paul Muntner, Richard S Cooper
Background -The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated a 27% reduction in all-cause mortality with a systolic blood-pressure (SBP) goal of <120 mmHg versus <140 mmHg among U.S. adults at high cardiovascular disease (CVD) risk but without diabetes, stroke, or heart failure. To quantify the potential benefits and risks of SPRINT intensive goal implementation, we estimated the deaths prevented and excess serious adverse events (SAEs) incurred if the SPRINT intensive SBP treatment goal was implemented in all eligible U...
February 13, 2017: Circulation
https://www.readbyqxmd.com/read/28178979/managed-care-and-inpatient-mortality-in-adults-effect-of-primary-payer
#19
Anika L Hines, Susan O Raetzman, Marguerite L Barrett, Ernest Moy, Roxanne M Andrews
BACKGROUND: Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor...
February 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28155919/obtaining-spontaneously-beating-cardiomyocyte-like-cells-from-adipose-derived-stromal-vascular-fractions-cultured-on-enzyme-crosslinked-gelatin-hydrogels
#20
Gang Yang, Zhenghua Xiao, Xiaomei Ren, Haiyan Long, Kunlong Ma, Hong Qian, Yingqiang Guo
Heart failure often develops after acute myocardial infarction because the injured myocardial tissue fails to recover or regenerate. Stem cell transplantation using adult cell sources, such as adipose-derived stromal vascular fraction (SVF), draws extensive attention. In this study, SVF cells were isolated from rat adipose tissue and cultivated on enzyme-crosslinked gelatin hydrogels. Morphological features of cell development and spontaneous beating behavior from these cells were observed and recorded. Cardiac phenotypes were characterized via immunofluorescence staining, and the expression of cardiac-specific genes was measured via RT-PCR...
February 3, 2017: Scientific Reports
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