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reduced heart rate variability and mortality

Robert M Carney, Kenneth E Freedland, Brian C Steinmeyer, Eugene H Rubin, Michael W Rich
OBJECTIVE: Depression is associated with an increased risk of mortality in patients with coronary heart disease (CHD). The risk may be reduced in patients who remit with adequate treatment, but few patients achieve complete remission. The purpose of this study was to identify the symptoms that persist despite aggressive treatment for depression in patients with CHD. METHODS: One hundred twenty-five patients with stable CHD who met the DSM-IV criteria for a moderate-to-severe major depressive episode completed treatment with cognitive behavior therapy (CBT), either alone or combined with an antidepressant, for up to 16 weeks...
March 8, 2018: Psychosomatic Medicine
Cristina Domingo, Fernando Aros, Agurtzane Otxandategi, Idoia Beistegui, Ariadna Besga, Pedro María Latorre
OBJECTIVE: To assess the efficacy of the ProMIC, multidisciplinary program for patients admitted at hospital because of heart failure (HF) programme, in reducing the HF-related readmission rate. DESING: Quasi-experimental research with control group. SETTINGS: Twelve primary health care centres and 3 hospitals from the Basque Country. PARTICIPANTS: Aged 40 years old or above patients admitted for HF with a New York Heart Association functional class II to IV...
February 26, 2018: Atencion Primaria
Sarah L Anderson, Joel C Marrs
This article reviews current literature on the role of pharmacists in the transition of care (TOC) for patients with heart failure (HF) and the impact of their contributions on therapeutic and economic outcomes. Optimizing the TOC for patients with HF from the hospital to the community/home is crucial for improving outcomes and decreasing high rates of hospital readmissions, which are associated with increased morbidity, mortality, and costs. A multidisciplinary team approach to the management of patients with HF facilitates the transition from the hospital to the ambulatory care setting, allowing for the consideration of medical, pharmacological, and lifestyle variables that impact the care of individual patients...
February 27, 2018: Advances in Therapy
Laurent Bitker, Florence Sens, Cécile Payet, Ségolène Turquier, Antoine Duclos, Vincent Cottin, Laurent Juillard
BACKGROUND: Pulmonary arterial hypertension (PAH) may lead to right heart failure and subsequently alter glomerular filtration rates (GFR). Chronic kidney disease (CKD, GFR <60 mL/min/1.73 m2) may also adversely affect PAH prognosis. This study aimed to assess how right heart hemodynamics was associated with reduced estimated GFR (eGFR) and the association of CKD with survival in PAH patients. METHODS: In a prospective PAH cohort (2003-2012), invasive hemodynamics and eGFR were collected at diagnosis (179 patients) and during follow-up (159 patients)...
February 22, 2018: American Journal of Nephrology
Zhen An, Yuefei Jin, Juan Li, Wen Li, Weidong Wu
PURPOSE OF REVIEW: Air pollution is established as an independent risk factor for cardiovascular diseases (CVDs). Ambient particulate matter (PM), a principal component of air pollutant, has been considered as a main culprit of the adverse effects of air pollution on human health. RECENT FINDINGS: Extensive epidemiological and toxicological studies have demonstrated particulate air pollution is positively associated with the development of CVDs. Short-term PM exposure can trigger acute cardiovascular events while long-term exposure over years augments cardiovascular risk to an even greater extent and can reduce life expectancy by a few years...
February 22, 2018: Current Allergy and Asthma Reports
Jacopo Alfonsi, Giacomo Murana, Henri G Smeenk, Hans Kelder, Marc Schepens, Uday Sonker, Wim J Morshuis, Robin H Heijmen
OBJECTIVES: Chronic, post-dissection thoraco-abdominal aortic aneurysms (TAAAs) are increasingly being treated by (hybrid) endovascular means. Although it is less invasive, thoracic endovascular aortic repair is technically complex with the risk of incomplete aneurysm exclusion, necessitating frequent reinterventions with potentially reduced long-term outcomes. The aim of this study was to evaluate contemporary early and late outcomes after open surgical repair of post-dissection TAAA...
February 16, 2018: European Journal of Cardio-thoracic Surgery
Hilal Yesil, Sibel Eyigor, Meral Kayıkcıoglu, Ruchan Uslu, Menekse Inbat, Benay Ozbay
Objective Heart rate variability (HRV) is a good indicator of the autonomic nervous system (ANS) activity. A few studies have been conducted recently and have shown a relationship between reduced HRV and conditions that lead to neuropathic pain (NP). In this study, we aimed to investigate whether NP is associated with changes in cardiac sympathovagal activity in patients with breast cancer (BC). Methods We used the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire to evaluate NP in 70 patients with BC...
February 15, 2018: Neurological Research
Oliver Riedel, C Ohlmeier, D Enders, A Elsässer, D Vizcaya, A Michel, S Eberhard, N Schlothauer, J Berg, E Garbe
BACKGROUND: Heart failure (HF) with reduced ejection fraction (HFrEF) has a worse prognosis than HF with preserved EF (HFpEF). The study aimed to evaluate whether different comorbidity profiles of HFrEF- and HFpEF-patients or HF-specific mechanisms contribute to a greater extent to this difference. METHODS: We linked data from two health insurances to data from a cardiology clinic hospital information system. Patients with a hospitalization with HF in 2005-2011, categorized as HFrEF (EF < 45%) or HFpEF (EF ≥ 45%), were propensity score (PS) matched to controls without HF on comorbidites and medication to assure similar comorbidity profiles of patients and their respective controls...
February 5, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Ying Wang, Hong Yang, Mark Nolan, John Burgess, Kazuaki Negishi, Thomas H Marwick
BACKGROUND: Depression is a prevalent, independent predictor of mortality in patients with heart failure (HF). Depression is also common in type 2 diabetes mellitus (T2DM), which is itself an important risk factor for HF. However, association of depression with incident HF in T2DM is undefined. The aim of the present study was to evaluate the predictive value of depression in predicting incident HF in a community-based cohort of asymptomatic patients with T2DM. METHODS: We prospectively recruited 274 asymptomatic T2DM patients ≥ 65 years (age 71 ± 4 year, 56% men) with preserved EF and no ischemic heart disease from a community-based population...
January 24, 2018: Cardiovascular Diabetology
Erik Sveberg Dietrichs, Brage Håheim, Timofei Kondratiev, Erik Traasdahl, Torkjel Tveita
BACKGROUND: Rewarming from accidental hypothermia is associated with cardiovascular dysfunction that complicates rewarming and contributes to a high mortality rate. We investigated autonomic cardiovascular control, as well as the separate effects of cooling, hypothermia and rewarming on hemodynamic function, aiming to provide knowledge of the pathophysiology causing such complications in these patients. METHODS: A rat model designed for circulatory studies during cooling, hypothermia (15{degree sign}C) and rewarming was used...
December 21, 2017: Journal of Applied Physiology
R De Vecchis, C Ariano, G Di Biase, M Noutsias
BACKGROUND: The combination drug sacubitril/valsartan was reported to be superior to enalapril in reducing all-cause death, cardiovascular mortality, and heart failure (HF) hospitalizations in patients with cardiac insufficiency and reduced left ventricular ejection fraction (HFREF) with NYHA class II-IV. METHODS: Our retrospective cohort study aimed to assess the effects of sacubitril/valsartan in addition to a beta-blocker and mineral receptor antagonist (MRA) in a group of HFREF patients with NYHA class II-III HF vs...
January 19, 2018: Herz
Paul Fergus, Malarvizhi Selvaraj, Carl Chalmers
Human visual inspection of Cardiotocography traces is used to monitor the foetus during labour and avoid neonatal mortality and morbidity. The problem, however, is that visual interpretation of Cardiotocography traces is subject to high inter and intra observer variability. Incorrect decisions, caused by miss-interpretation, can lead to adverse perinatal outcomes and in severe cases death. This study presents a review of human Cardiotocography trace interpretation and argues that machine learning, used as a decision support system by obstetricians and midwives, may provide an objective measure alongside normal practices...
December 8, 2017: Computers in Biology and Medicine
Ingrid C de Jong, Johan van Riel, Marc B M Bracke, Henry van den Brand
A 'meta-analysis' was performed to determine effects of post-hatch food and water deprivation (PHFWD) on chicken development, performance and welfare (including health). Two types of meta-analysis were performed on peer-reviewed scientific publications: a quantitative 'meta-analysis' (MA) and a qualitative analysis (QA). Previously reported effects of PHFWD were quantified in the MA, for variables related to performance, mortality and relative yolk sac weight. The QA counted the number of studies reporting (non-)significant effects when five or more records were available in the data set (i...
2017: PloS One
C Lal, M Kaur, A K Jaryal, K K Deepak, D Bhowmik, S K Agarwal
High cardiovascular morbidity and mortality is observed in predialytic chronic kidney disease (CKD) patients. The underlying mechanism of cardiovascular dysfunction often remains unclear. The present study was designed to perform multiparametric assessment of baroreflex sensitivity (BRS), arterial stiffness indices, and cardiovascular variabilities (heart rate variability [HRV] and blood pressure variability [BPV]) together in predialytic CKD patients; compare it with normal healthy controls; and determine their relationships in predialytic nondiabetic CKD patients...
November 2017: Indian Journal of Nephrology
Andrzej Bissinger
Background: Cardiac autonomic neuropathy (CAN) is a frequent but underdiagnosed complication of diabetes mellitus. It has a strong influence on various cardiac disorders including myocardial ischemia and infarction, hypertension, orthostatic hypotonia, heart failure, and arrhythmias. CAN can lead to severe morbidity and mortality and increase the risk of sudden cardiac death. Methods: This review article summarizes the latest evidence regarding the epidemiology, pathogenesis, influence on the cardiovascular system, and diagnostic methods for CAN...
2017: Journal of Diabetes Research
Grietje E de Vries, Peter J Wijkstra, Ewout J Houwerzijl, Huib A M Kerstjens, Aarnoud Hoekema
Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. This study systematically reviews the effects of oral appliance therapy (OAT) on a broad spectrum of cardiovascular outcomes. A literature search was performed up to December 31st 2016. Twenty-five relevant full-text articles were retrieved. Sixteen articles were considered methodologically sufficient, including 11 randomized controlled trials. Pooled data of the RCTs showed significant reductions in daytime systolic and diastolic blood pressure compared to baseline, but no significant reductions in heart rate, except for daytime heart rate when compared to inactive/placebo OAT...
October 26, 2017: Sleep Medicine Reviews
Ulrik M Mogensen, Lars Køber, Pardeep S Jhund, Akshay S Desai, Michele Senni, Søren L Kristensen, Andrej Dukát, Chen-Huan Chen, Felix Ramires, Martin P Lefkowitz, Margaret F Prescott, Victor C Shi, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Milton Packer, John J V McMurray
AIMS: Elevated serum uric acid concentration (SUA) has been associated with an increased risk of cardiovascular disease, but this may be due to unmeasured confounders. We examined the association between SUA and outcomes as well as the effect of sacubitril/valsartan on SUA in patients with heart failure with reduced ejection fraction (HFrEF) in PARADIGM-HF. METHODS AND RESULTS: The association between SUA and the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization, its components, and all-cause mortality was examined using Cox regression analyses among 8213 patients using quintiles (Q1-Q5) of SUA adjusted for baseline prognostic variables including estimated glomerular filtration rate (eGFR), diuretic dose, and log N-terminal pro-brain natriuretic peptide...
November 30, 2017: European Journal of Heart Failure
W Hamm, L Stülpnagel, N Vdovin, G Schmidt, K D Rizas, A Bauer
AIM: Most deaths after myocardial infarction (MI) occur in patients with normal or moderately reduced left ventricular ejection fraction (LVEF >35%). Periodic repolarization dynamics (PRD) and deceleration capacity (DC) are novel ECG-based markers related to sympathetic and vagal cardiac autonomic nervous system activity. Here, we test the combination of PRD and DC to predict risk in post-infarction patients with LVEF >35%. METHODS AND RESULTS: We included 823 survivors of acute MI with LVEF >35%, aged ≤80years and in sinus rhythm...
December 15, 2017: International Journal of Cardiology
Robert Lewis, Brek Wilkins, Bruce Benjamin, J Thomas Curtis
Social support structures reduce mortality and morbidity in humans, but the mechanisms underlying these reductions are not fully understood. The prevailing hypothesis is that social support buffers stress and reduces allostatic load, thereby increasing longevity. However, the possibility that affiliative social interactions confer health benefits independent of stress buffering is understudied. We examined autonomic function in prairie voles - arguably the premier species for modeling human social affiliation - to assess the possibility that the formation of strong social bonds alters autonomic function and contributes to health benefits...
October 2, 2017: Autonomic Neuroscience: Basic & Clinical
Mohamed B Elshazly, Todd Senn, Yuping Wu, Bruce Lindsay, Walid Saliba, Oussama Wazni, Leslie Cho
BACKGROUND: Atrial fibrillation (AF) has been objectively associated with exercise intolerance in patients with heart failure with reduced ejection fraction; however, its impact in patients with heart failure with preserved ejection fraction has not been fully scrutinized. METHODS AND RESULTS: We identified 1744 patients with heart failure and ejection fraction ≥50% referred for cardiopulmonary stress testing at the Cleveland Clinic (Cleveland, OH), 239 of whom had AF...
October 31, 2017: Journal of the American Heart Association
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