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Refractory heart failure

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https://www.readbyqxmd.com/read/28319520/infections-in-patients-with-a-total-artificial-heart-are-common-but-rarely-fatal
#1
Luis F Hidalgo, Keyur B Shah, Richard H Cooke, Daniel G Tang, Vigneshwar Kasirajan, Howard A Cooper, Wilbert S Aronow
Patients who received a total artificial heart (TAH) at Virginia Commonwealth University (VCU) between January 1, 2010 and December 31, 2011 were identified from the VCU Mechanical Circulatory Support Clinical Database. Retrospective data extraction from the medical records was performed from the time of TAH implantation until heart transplantation or death. Infections were classified as confirmed or suspected. Twenty-seven men and 5 women, mean age 49.5 years (range 24 to 68 years) received a TAH. The mean duration of TAH support was 225 days (range 1 to 1334 days)...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28316327/obstructive-primary-cardiac-t-cell-lymphoma-a-case-report-from-senegal
#2
Simon Antoine Sarr, Abdou Majib Gaye, Fatou Aw, Jean de Dieu Nzambaza, Malick Bodian, Kana Babaka, Mouhamadou Bamba Ndiaye, Adama Kane, Maboury Diao, Serigne Abdou Ba
BACKGROUND Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis. CASE REPORT Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea. On admission, examination revealed an irregular tachycardia at 170 beats per minute (bpm) and congestive heart failure. The electrocardiogram scored full tachyarrhythmia by atrial fibrillation with an average ventricular rate of 179 cycles per minute...
March 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28315488/sorafenib-as-a-potential-strategy-for-refractory-pulmonary-arterial-hypertension
#3
Gou Kimura, Masaharu Kataoka, Takumi Inami, Keiichi Fukuda, Hideaki Yoshino, Toru Satoh
Sorafenib is an inhibitor of multi-kinases including tyrosine and serine/threonine kinases. We investigated the efficacy and safety of sorafenib for the treatment of patients with refractory pulmonary arterial hypertension (PAH). Sorafenib was started in 9 patients (7 with idiopathic PAH, 2 with pulmonary veno-occlusive disease) who had severe PAH and right heart failure, in spite of treatment with vasodilators specific for PAH. Sorafenib was started as an add-on therapy at a dose of 50 or 100 mg/day, and increased to 100-400 mg/day...
March 14, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28304402/prospective-longitudinal-study-on-quality-of-life-in-relapsed-refractory-multiple-myeloma-patients-receiving-second-or-third-line-lenalidomide-or-bortezomib-treatment
#4
X Leleu, C Kyriakou, I Vande Broek, P Murphy, P Bacon, P Lewis, H Gilet, B Arnould, M T Petrucci
Treatment advances for multiple myeloma (MM) that have prolonged survival emphasise the importance of measuring patients' health-related quality of life (HRQoL) in clinical studies. HRQoL/functioning and symptoms of patients with relapsed/refractory MM (RRMM) receiving second- or third-line lenalidomide or bortezomib treatment were measured in a prospective European multicentre, observational study at different time points. At baseline, patients in the lenalidomide cohort were frailer than in the bortezomib cohort with more rapid disease progression at study entry (more patients with Eastern Cooperative Oncology Group performance status >2, shorter time from diagnosis, more chronic heart failure, higher serum creatinine levels, more patients with dialysis required)...
March 17, 2017: Blood Cancer Journal
https://www.readbyqxmd.com/read/28284503/renal-denervation-regulates-the-atrial-arrhythmogenic-substrates-through-reverse-structural-remodeling-in-heart-failure-rabbit-model
#5
Shinya Yamada, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Shih-Lin Chang, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: Heart failure (HF) causes atrial remodeling and increases the incidence of atrial fibrillation (AF). Renal denervation (RDN) has been shown to decrease the development of AF. This study aimed to identify the effects of RDN on the atrial arrhythmogenic substrates in HF. METHODS: Rabbits were classified into four groups: control (n=9), RDN (n=10), HF (n=6) and HF-RDN (n=9). Surgical and chemical RDN was approached through bilateral retroperitoneal flank incisions in RDN and HF-RDN...
February 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28283677/guillain-barr%C3%A3-syndrome-presenting-with-sinus-node-dysfunction-and-refractory-shock
#6
Le Dung Ha, Farrukh Abbas, Mohan Rao
BACKGROUND Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that is usually associated with preceding respiratory or gastrointestinal infection and has the hallmark manifestation of ascending flaccid paralysis. We report an atypical presentation of GBS. CASE REPORT A 76-year-old male presented with acute onset of diaphoresis and altered mental status. He subsequently developed severe bradycardia and refractory hypotension, which initially responded to dopamine infusion. A temporary pacemaker wire was placed to stabilize the heart rate but hypotension persisted...
March 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28279501/long-term-follow-up-after-trans-catheter-tricuspid-valve-in-valve-replacement-with-balloon-expandable-aortic-valves
#7
Roberto Scarsini, Mattia Lunardi, Gabriele Pesarini, Fausto Castriota, Mauro Feola, Valeria Ferrero, Giuseppe Faggian, Corrado Vassanelli, Flavio Ribichini
BACKGROUND: Transcatheter tricuspid VIV replacement has been proposed as a feasible option for high-risk patients with previous tricuspid valve replacement that undergo valve degeneration causing refractory heart failure. However, little is known about the long-term outcome of patients treated with transcatheter tricuspid VIV. We evaluate the safety of transcatheter tricuspid valve-in-valve (VIV) replacement by using balloon-expandable aortic valve stents and the long-term follow-up. METHODS AND RESULTS: From January 2013 to March 2016, 4 patients underwent transcatheter tricuspid VIV in our center using balloon-expandable Edwards Sapien-XT and Sapien-3 valves...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28262346/effective-suppression-of-atrial-fibrillation-by-ivabradine-novel-target-for-an-established-drug
#8
Gerrit Frommeyer, Magdalena Sterneberg, Dirk G Dechering, Christian Ellermann, Nils Bögeholz, Simon Kochhäuser, Christian Pott, Michael Fehr, Lars Eckardt
BACKGROUND: Ivabradine is an inhibitor of mixed Na(+)-K(+)-currents and routinely administered in chronic heart failure. Clinical studies reported divergent trends regarding proarrhythmic and antiarrhythmic effects in atrial fibrillation (AF). METHODS AND RESULTS: In 12 isolated rabbit hearts AF was induced in 7 of 12 hearts (13 episodes) under baseline conditions by a standardized protocol employing atrial burst pacing. Thereafter, a combination of acetylcholine and isoproterenol was employed to enhance AF occurrence...
February 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28260473/perioperative-venoarterial-extracorporeal-membrane-oxygenation-support-during-heart-transplant
#9
Ender Gedik, Funda Atar, Aycan Ozdemirkan, Aynur Camkiran Firat, Pinar Zeyneloglu, Atilla Sezgin, Arash Pirat
OBJECTIVES: Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. This technique may be used after heart transplant for conditions refractory to medical treatment like primary graft failure. Previously, we reported our experience with patients who received extracorporeal support as a bridge to emergency heart transplant. In this study, we present our perioperative experience with heart transplants in which extracorporeal support was used...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28243893/successful-management-of-antibody-mediated-rejection-after-cardiac-transplantation-in-a-patient-supported-by-a-left-ventricular-assist-device-for-more-than-3%C3%A2-years
#10
Masatoshi Akiyama, Shingo Takahara, Satoshi Kawatsu, Yoichi Endo, Junko Fujiwara, Osamu Adachi, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki
Due to donor shortage, patients with refractory heart failure need to be supported on mechanical circulatory support (MCS). Critically, patients undergo several deployments of MCS in stages inevitably requiring blood products transfusion. MCSs per se along with blood products can trigger immune allosensitization. Antibody-mediated rejection (AMR) is associated with significant mortality after heart transplantation. Here, we present the case with high panel-reactive antibody over 95% who developed AMR early after heart transplantation...
February 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28235633/cell-therapy-for-heart-disease-after-15-years-unmet-expectations
#11
REVIEW
Patrizia Nigro, Beatrice Bassetti, Laura Cavallotti, Valentina Catto, Corrado Carbucicchio, Giulio Pompilio
Over the past two decades cardiac cell therapy (CCT) has emerged as a promising new strategy to cure heart diseases at high unmet need. Thousands of patients have entered clinical trials for acute or chronic heart conditions testing different cell types, including autologous or allogeneic bone marrow (BM)-derived mononuclear or selected cells, BM- or adipose tissue-derived mesenchymal cells, or cardiac resident progenitors based on their potential ability to regenerate scarred or dysfunctional myocardium. Nowadays, the original enthusiasm surrounding the regenerative medicine field has been cushioned by a cumulative body of evidence indicating an inefficient or modest efficacy of CCT in improving cardiac function, along with the continued lack of indisputable proof for long-term prognostic benefit...
February 21, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28216453/quantification-of-myocardial-oxygenation-in-heart-failure-using-blood-oxygen-level-dependent-t2-magnetic-resonance-imaging-comparison-with-cardiopulmonary-exercise-test
#12
Michinobu Nagao, Yuzo Yamasaki, Satoshi Kawanami, Takeshi Kamitani, Koji Sagiyama, Taiki Higo, Tomomi Ide, Atsushi Takemura, Umiko Ishizaki, Kenji Fukushima, Yuji Watanabe, Hiroshi Honda
PURPOSE: Quantification of myocardial oxygenation (MO) in heart failure (HF) has been less than satisfactory. This has necessitated the use of invasive techniques to measure MO directly or to determine the oxygen demand during exercise using the cardiopulmonary exercise (CPX) test. We propose a new quantification method for MO using blood-oxygen-level-dependent (BOLD) myocardial T2* magnetic resonance imaging (M-T2* MRI), and investigate its correlation with CPX results. METHODS: Thirty patients with refractory HF who underwent cardiac MRI and CPX test for heart transplantation, and 24 healthy, age-matched volunteers as controls were enrolled...
February 17, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28191605/integrating-palliative-care-into-routine-care-of-patients-with-heart-failure-models-for-clinical-collaboration
#13
REVIEW
Warren H Lewin, Kristen G Schaefer
Heart failure (HF) affects nearly 5.7 million Americans and is described as a chronic incurable illness carrying a poor prognosis. Patients living with HF experience significant symptoms including dyspnea, pain, anxiety, fatigue, and depression. As the illness advances into later stages, symptoms become more intense and refractory to standard treatments, leading to recurrent acute-care utilization and contributing to poor quality of life. Advanced HF symptoms have been described to be as burdensome, if not more than, those in cancer populations...
February 13, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28190605/the-importance-of-age-and-weight-on-cavopulmonary-shunt-stage-ii-outcomes-after-the-norwood-procedure-planned-versus-unplanned-surgery
#14
David J Barron, Intisar Ul Haq, Adrian Crucean, John Stickley, Phil Botha, Natasha Khan, Timothy J Jones, William J Brawn
OBJECTIVE: The study objective was to evaluate the outcomes of the cavopulmonary shunt after the Norwood procedure with a particular focus on age, weight, and whether surgery was planned or expedited by clinical findings. METHODS: We studied 297 consecutive patients with hypoplastic left heart syndrome undergoing the cavopulmonary shunt operation between 2002 and 2014. All patients underwent the Norwood procedure with a right ventricle to pulmonary artery conduit...
January 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28190577/dilated-cardiomyopathy
#15
REVIEW
Robert G Weintraub, Christopher Semsarian, Peter Macdonald
Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction. Genetic mutations involving genes that encode cytoskeletal, sarcomere, and nuclear envelope proteins, among others, account for up to 35% of cases. Acquired causes include myocarditis and exposure to alcohol, drugs and toxins, and metabolic and endocrine disturbances. The most common presenting symptoms relate to congestive heart failure, but can also include circulatory collapse, arrhythmias, and thromboembolic events...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/28186837/methadone-and-corrected-qt-prolongation-in-pain-and-palliative-care-patients-a-case-control-study
#16
Katherine M Juba, Tina M Khadem, David J Hutchinson, Jack E Brown
BACKGROUND: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients. OBJECTIVE: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28168785/intermediate-term-hemodynamic-effects-of-single-inferior-vena-cava-valve-implant-for-the-treatment-of-severe-tricuspid-regurgitation
#17
Val Rakita, Vladimir Lakhter, Pravin Patil, Brian P O'Neill
Severe tricuspid regurgitation (TR) remains a vastly undertreated disease, with sustained elevation of right atrial (RA) pressure directly resulting in chronic end-organ damage. Recently, bi-caval valve implantation has been shown to improve symptoms in patients with symptomatic TR who are at high risk for surgery. We present the first report of intermediate term hemodynamic effects of single inferior vena cava (IVC) valve implantation (CAVI) for treatment of severe TR. We performed CAVI on a 66-year-old female with severe TR, who suffered from repeat hospitalizations for treatment refractory NYHA class III-IV heart failure symptoms and had prohibitive operative risk...
February 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28161113/-myocarditis
#18
G Hékimian, A Combes
Acute myocarditis must be considered in patients with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackie virus and adenovirus being the most frequently viruses responsible for the disease. In this setting, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted...
February 1, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28153551/current-and-future-percutaneous-strategies-for-the-treatment-of-acute-and-chronic-heart-failure
#19
Ignacio J Amat-Santos, Luis H Varela-Falcón, William T Abraham
The prevalence of heart failure (HF) has risen in parallel with improved survival in patients after a myocardial infarction and an aging population worldwide. In recent years, new percutaneous therapies have been developed to complement current established treatments for acute/decompensated and chronic HF and minimize risks. In acute presentations, the failure of medical treatment is no longer the end of the road in refractory circulatory shock; the use of mechanical circulatory support devices may be the next milestone in well-resourced health settings...
January 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28146193/-cytomegalovirus-disease-in-post-heart-transplant-patients-at-a-national-reference-center
#20
Christian Rojas-Contreras, Gabriel De la Cruz-Ku, Bryan Valcarcel-Valdivia
INTRODUCTION: Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. AIMS: To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. MATERIALS AND METHODS: A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015...
December 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
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