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Daisuke Matsutani, Masaya Sakamoto, Hiroyuki Iuchi, Souichirou Minato, Hirofumi Suzuki, Yosuke Kayama, Norihiko Takeda, Ryuzo Horiuchi, Kazunori Utsunomiya
BACKGROUND: It is presently unclear whether glycemic variability (GV) is associated with baroreflex sensitivity (BRS), which is an early indicator of cardiovascular autonomic neuropathy. The present study is the first to examine the relationships between BRS and GV measured using continuous glucose monitoring (CGM). METHODS: This was a multicenter, prospective, open-label clinical trial. A total of 102 patients with type 2 diabetes were consecutively recruited for this study...
March 7, 2018: Cardiovascular Diabetology
Sarah Seiler-Mussler, Anne S Limbach, Insa E Emrich, John W Pickering, Heinz J Roth, Danilo Fliser, Gunnar H Heine
BACKGROUND AND OBJECTIVES: In patients with CKD, elevated plasma parathyroid hormone (PTH) levels are associated with greater cardiovascular morbidity and mortality. However, the reference method for PTH measurement is disputed. It has been argued that measurement of nonoxidized PTH better reflects biologically active PTH than measurements with conventional assays. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: PTH and nonoxidized PTH levels were measured at study baseline in 535 patients with CKD with an eGFR range between 89 and 15 ml/min per 1...
March 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Shinro Matsuo, Kenichi Nakajima, Yasuchika Takeishi, Tsunehiko Nishimura
BACKGROUND: The purpose of this study is to test the hypothesis that a normal myocardial perfusion imaging (MPI) study in chronic kidney disease (CKD) can provide benign prognostic information for the prediction of major cardiovascular events. METHODS: The study group consisted of 431 CKD patients (males, 64%; mean age, 72 ± 11 years) with normal SPECT imaging. Based on SPECT image and QGS data, 331 had a summed stress score of 3 or less, a summed difference score of 1 or less and normal cardiac function (males; end-systolic volume (ESV) ≤ 60 ml, females; ESV ≤ 40 ml, males, ejection fraction (EF) ≥ 49%; females, EF ≥ 50%)...
March 3, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Francesc Formiga, Rafael Moreno-Gonzalez, David Chivite, Jesús Casado, Francesc Escrihuela-Vidal, Xavier Corbella
INTRODUCTION AND OBJECTIVES: Chronic kidney disease is related to poor outcomes in patients with heart failure (HF). Few studies have assessed whether renal function influences one-year mortality risk in patients admitted for the first time for acute HF. METHODS: We reviewed the medical records of all patients aged >50 years admitted within a two-year period for a first episode of decompensated HF. The sample was divided according to the patients' estimated glomerular filtration rate (eGFR) on admission into three groups (eGFR >60, 30-60 and <30 ml/min/1...
February 28, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Mohammed K Ali, Kai McKeever Bullard, Sharon Saydah, Giuseppina Imperatore, Edward W Gregg
BACKGROUND: There is controversy over the usefulness of prediabetes as a diagnostic label. Using data from US National Health and Nutrition Examination Surveys (NHANES) between 1988 and 2014, we examined the cardiovascular and renal burdens in adults with prediabetes over time and compared patterns with other glycaemic status groups. METHODS: We analysed cross-sectional survey data from non-pregnant adults aged 20 years and older from the NHANES survey periods 1988-94, 1999-2004, 2005-10, and 2011-14...
February 27, 2018: Lancet Diabetes & Endocrinology
Michael S Kiernan, Susanna R Stevens, W H Wilson Tang, Javed Butler, Kevin J Anstrom, Edo Y Birati, Justin L Grodin, Divya Gupta, Kenneth B Margulies, Shane LaRue, Victor G Dávila-Román, Adrian F Hernandez, Lisa de Las Fuentes
BACKGROUND: Poor response to loop diuretic therapy is a marker of risk during acute heart failure hospitalization. We sought to describe baseline determinants of diuretic response and to further explore the relationship between this response and clinical outcomes. METHODS AND RESULTS: Patient data from the NHLBI Heart Failure Network ROSE-AHF and CARRESS-HF clinical trials were analyzed to determine baseline determinants of diuretic response. Diuretic efficiency (DE) was defined as total 72h fluid output per total equivalent loop diuretic dose; subjects were stratified to high and low DE groups by the median value...
February 23, 2018: Journal of Cardiac Failure
Julio A Lamprea-Montealegre, Robyn L McClelland, Morgan Grams, Pamela Ouyang, Moyses Szklo, Ian H de Boer
OBJECTIVE: This study sought to characterise the main dyslipidaemic phenotypes present in chronic kidney disease (CKD) and their association with coronary heart disease (CHD) risk. METHODS: Analyses included 6612 individuals in the multiethnic study of atherosclerosis free of CHD at baseline. CKD was defined as an estimated glomerular filtration rate (eGFR) of 15 to <60 mL/min/1.73 m2 (stages 3-4). Principal component analyses were used to characterise the main dyslipidaemic phenotypes of CKD accounting for the correlation among different lipoproteins and lipoprotein particles...
February 22, 2018: Heart: Official Journal of the British Cardiac Society
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)...
2018: American Journal of Nephrology
Mohinder Vindhyal, Shravani R Vindhyal, Travis Haneke, Paul M Ndunda, Freidy Eid, K James Kallail
Introduction Atrial fibrillation (AF), the most common cardiac arrhythmia, affects approximately 2.3 million patients in the United States, costing around $26 billion. Atrial fibrillation is associated with a two- to seven-fold increased risk of stroke, one of the most serious complications. Chronic kidney disease affects approximately 13% of the US population and has been associated with higher rates of AF than the general population. In patients with chronic kidney disease (CKD), the risk of stroke increases as the glomerular filtration rate (GFR) decreases, especially in CKD stages three and four...
December 11, 2017: Curēus
Rita Ilhão Moreira, Pedro Silva Cunha, Pedro Rio, Manuel Nogueira da Silva, Luísa Moura Branco, Ana Galrinho, Joana Feliciano, Rui Soares, Rui Cruz Ferreira, Mário Martins Oliveira
PURPOSE: Renal dysfunction is often associated with chronic heart failure, leading to increased morbi-mortality. However, data regarding these patients after cardiac resynchronization therapy (CRT) is sparse. We sought to evaluate response and long-term mortality in patients with heart failure and renal dysfunction and assess renal improvement after CRT. METHODS: We analyzed 178 consecutive patients who underwent successful CRT device implantation (age 64 ± 11 years; 69% male; 92% in New York Heart Association (NYHA) functional class ≥ III; 34% with ischemic cardiomyopathy)...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Rakesh Malhotra, Loren Lipworth, Kerri L Cavanaugh, Bessie A Young, Katherine L Tucker, Teresa C Carithers, Herman A Taylor, Adolfo Correa, Edmond K Kabagambe, T Alp Ikizler
OBJECTIVE: Dietary protein intake could have deleterious renal effects in populations at risk for chronic kidney disease. Here, we examined whether higher protein intake (≥80th percentile of energy from protein) is associated with decline in kidney function and whether this decline varies by diabetes status. DESIGN: Observational cohort study. SUBJECTS AND SETTINGS: Participants were African-Americans (n = 5,301), who enrolled in the Jackson Heart Study between 2000 and 2004...
February 13, 2018: Journal of Renal Nutrition
Stanford E Mwasongwe, Tibor Fülöp, Ronit Katz, Solomon K Musani, Mario Sims, Adolfo Correa, Michael F Flessner, Bessie A Young
Whether elevated uric acid (UA) is an independent risk factor for chronic kidney disease (CKD) is not well established. The authors evaluated the relationship of UA with rapid kidney function decline (RKFD) and incident CKD among 3702 African Americans (AAs) in the Jackson Heart Study with serum UA levels measured at baseline exam (2000-2004). RKFD was defined as ≥ 30% eGFR loss and incident CKD as development of eGFR < 60 mL/min/1.73 m 2 with a ≥ 25% decline in eGFR between baseline and exam 3 (2009-2013)...
February 16, 2018: Journal of Clinical Hypertension
Peter Hayes, Hannah Kielty, Monica Casey, Liam G Glynn, Gerard J Molloy, Hannah Durand, John Newell, Andrew W Murphy
Background: Most cases of hypertension can be effectively treated with lifestyle changes together with medications, but within this population lies a group with more difficult to treat hypertension-those with apparent treatment-resistant hypertension (aTRH). The American Heart Association and the UK National Institute for Health and Care Excellence have both highlighted the need for further research into the prognosis of patients with resistant hypertension, both apparent and true. Methods: In 16 practices affiliated to a university research network, 646 patients had been identified with apparent treatment-resistant hypertension...
2018: Pilot and Feasibility Studies
Kathryn C B Tan, Ching-Lung Cheung, Alan C H Lee, Joanne K Y Lam, Ying Wong, Sammy W M Shiu
AIMS/HYPOTHESIS: Galectin-3 has been implicated in cardiac and renal fibrosis and serves as a prognostic clinical indicator in heart failure. The aim of the present study was to evaluate whether serum galectin-3 level is associated with progressive kidney disease in type 2 diabetes. METHODS: Galectin-3 was measured in baseline samples by ELISA in 1320 participants with type 2 diabetes with eGFR ≥30 ml min-1 1.73 m-2 . The primary outcome was defined as doubling of serum creatinine and/or initiation of renal replacement therapy during follow-up...
February 7, 2018: Diabetologia
Caojian Zuo, Xiaodong Li, Jun Huang, Dongrui Chen, Kaida Ji, Yan Yang, Tingyan Xu, Ding-Liang Zhu, Chen Yan, Pingjin Gao
Aims: Cardiac myofibroblasts (CMFs) play a crucial role in the progression of pathological fibrotic cardiac remodeling. The expression of osteoglycin (OGN) is increased in diseased hearts; however, the role of OGN in pathological cardiac remodeling is not understood. Here we sought to determine the effect of OGN on cardiac interstitial fibrosis and investigated the molecular mechanisms of OGN in CMF activation and matrix production. Methods and results: We found that OGN expression was significantly upregulated in mouse hearts in response to chronic 14-day angiotensin II (Ang II) infusion...
February 5, 2018: Cardiovascular Research
Tao Wang, Yan Zhang, Ning Wang, Qiong Liu, ZeKai Wang, Bing Liu, Kai Niu
PURPOSE: Since altered sympathetic nerve activity and insulin resistance are implicated in the pathogenesis of type 2 diabetic nephropathy, we investigated the effect of polymorphic Arg16Gly and Gln27Glu in the β2 adrenoceptor gene and Ala54Thr in the fatty acid binding protein 2 gene on the estimated glomerular filtration rate (eGFR) in Chinese patients with the above disease. METHODS: A total of 552 diabetic subjects recruited from annual health examinations were studied...
February 5, 2018: International Urology and Nephrology
Melanie P Chin, George L Bakris, Geoffrey A Block, Glenn M Chertow, Angie Goldsberry, Lesley A Inker, Hiddo J L Heerspink, Megan O'Grady, Pablo E Pergola, Christoph Wanner, David G Warnock, Colin J Meyer
BACKGROUND: Increases in measured inulin clearance, measured creatinine clearance, and estimated glomerular filtration rate (eGFR) have been observed with bardoxolone methyl in 7 studies enrolling approximately 2,600 patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). The largest of these studies was Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes (BEACON), a multinational, randomized, double-blind, placebo-controlled phase 3 trial which enrolled patients with T2D and CKD stage 4...
2018: American Journal of Nephrology
Laetitia Dou, Stéphane Poitevin, Marion Sallée, Tawfik Addi, Bertrand Gondouin, Nathalie McKay, Michael S Denison, Noémie Jourde-Chiche, Ariane Duval-Sabatier, Claire Cerini, Philippe Brunet, Françoise Dignat-George, Stéphane Burtey
Patients with chronic kidney disease (CKD) are exposed to uremic toxins and have an increased risk of cardiovascular disease. Some uremic toxins, like indoxyl sulfate, are agonists of the transcription factor aryl hydrocarbon receptor (AHR). These toxins induce a vascular procoagulant phenotype. Here we investigated AHR activation in patients with CKD and in a murine model of CKD. We performed a prospective study in 116 patients with CKD stage 3 to 5D and measured the AHR-Activating Potential of serum by bioassay...
January 22, 2018: Kidney International
Mingzhu Xu, Tingbo Jiang, Yafeng Zhou, Xiangjun Yang
Fulminant myocarditis is a severe cardiac emergency that may lead to death if effective cardiopulmonary supports are not provided. This study aimed to evaluate the prognostic predictors in patients with fulminant myocarditis.We retrospectively analyzed the clinical characteristics, complications, laboratory findings, treatments, as well as electrocardiographic and echocardiographic data of 73 consecutive subjects diagnosed with fulminant myocarditis from June 2012 to June 2016. Logistic regression analysis was used to identify the independent predictive factors of nonsurvivor fulminant myocarditis...
February 2018: Medicine (Baltimore)
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACEI = angiotensin-converting enzyme inhibitor; ADVANCE = Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BCR-QR = bromocriptine quick release; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CHD = coronary heart disease; CKD = chronic kidney disease; CVD = cardiovascular disease; DASH = Dietary Approaches to Stop Hypertension; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density lipoprotein cholesterol; IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial; LDL-C = low-density lipoprotein cholesterol; LDL-P = low-density lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium glucose cotransporter-2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione; VADT = Veterans Affairs Diabetes Trial...
January 2018: Endocrine Practice
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