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Refractory heart failure

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https://www.readbyqxmd.com/read/29788286/extracorporeal-life-support-for-primary-graft-dysfunction-after-heart-transplantation
#1
Matteo Pozzi, Chiara Bottin, Xavier Armoiry, Laurent Sebbag, Pascale Boissonnat, Elisabeth Hugon-Vallet, Catherine Koffel, Claire Flamens, Sylvie Paulus, Jean Luc Fellahi, Jean Francois Obadia
OBJECTIVES: Survival after heart transplantation is steadily improving but primary graft dysfunction (PGD) is still a leading cause of death. Medical management seems useful in mild or moderate PGD, whereas extracorporeal life support (ECLS) could be suggested for severe PGD refractory to conventional treatment. Our aim is to present the results of ECLS for PGD after heart transplantation at a single-centre experience. METHODS: We performed an observational analysis of our local database...
May 17, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29788278/prognostic-value-of-left-ventricular-reverse-remodelling-and-recurrent-mitral-regurgitation-after-personalized-surgical-treatment-of-patients-with-non-ischaemic-cardiomyopathy-and-functional-mitral-regurgitation
#2
Annelieke H J Petrus, Laurens F Tops, Eva Timmer, Michel I M Versteegh, Olaf M Dekkers, Robert J M Klautz, Jerry Braun
OBJECTIVES: The aim of this study was to determine the prevalence of left ventricular reverse remodelling (LVRR) and recurrent mitral regurgitation (MR) at mid-term follow-up (1-2 years after surgery) in patients after personalized surgical treatment of heart failure and functional MR due to non-ischaemic cardiomyopathy and to assess their prognostic impact on long-term clinical outcomes. METHODS: Consecutive patients with refractory heart failure and non-ischaemic MR, who underwent mitral valve surgery with or without additional procedures, were identified...
May 19, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29779928/the-diagnosis-and-clinical-management-of-the-catastrophic-antiphospholipid-syndrome-a-comprehensive-review
#3
REVIEW
Ricard Cervera, Ignasi Rodríguez-Pintó, Gerard Espinosa
The catastrophic antiphospholipid syndrome (CAPS) is a life-threating variant of the antiphospholipid syndrome characterized by the development of multiple thrombosis in a short period of time, usually ending up in the failure of function of several vital organs. Most CAPS episodes are related to a prothrombotic situation or precipitating factor such as infections, surgical procedures or malignant diseases. In patients with CAPS, the development of multiple thrombosis leads to an important cytokine release that worsens the already critical patient's situation...
May 17, 2018: Journal of Autoimmunity
https://www.readbyqxmd.com/read/29774392/cost-effectiveness-of-ventricular-assist-device-destination-therapy-for-advanced-heart-failure-in-duchenne-muscular-dystrophy
#4
Defne A Magnetta, JaHyun Kang, Peter D Wearden, Kenneth J Smith, Brian Feingold
Destination ventricular assist device therapy (DT-VAD) is well accepted in select adults with medically refractory heart failure (HF) who are not transplant candidates; however, its use in younger patients with progressive diseases is unclear. We sought to evaluate the cost-effectiveness of DT-VAD in Duchenne muscular dystrophy (DMD) patients with advanced HF. We created a Markov-state transition model (5-year horizon) to compare survival, costs, and quality of life (QOL) between medical management and DT-VAD in DMD with advanced HF...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29766321/acute-kidney-injury-after-implantation-of-a-left-ventricular-assist-device-a-comparison-of-axial-flow-heartmate-ii-and-centrifugal-flow-heartware-hvad-devices
#5
Azeen Anjum, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Whitson B Etheridge, Reynolds M Delgado, Leo Simpson, Joggy K George, Ajith P Nair, O H Frazier, Jeffrey A Morgan
Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly being used to treat advanced, refractory chronic heart failure. Herein, we sought to determine the incidence of postoperative acute kidney injury (AKI) in axial-flow (HeartMate II; HM-II) and centrifugal-flow (HVAD) CF-LVAD recipients, as well as the effect of AKI on mortality. The study cohort comprised 520 patients who received a HM-II (n = 398) or HVAD (n = 122) at our center between November 2003 and March 2016. Their records were reviewed to determine the incidence of RIFLE-defined AKI after LVAD implantation...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29765615/prognostic-significance-of-repeated-brain-natriuretic-peptide-measurements-after-percutaneous-transluminal-septal-myocardial-ablation-in-patients-with-drug-refractory-hypertrophic-obstructive-cardiomyopathy
#6
Keitaro Akita, Hikaru Tsuruta, Shinsuke Yuasa, Mitsushige Murata, Keiichi Fukuda, Yuichiro Maekawa
Objectives: To evaluate whether repeated brain natriuretic peptide (BNP) measurements after percutaneous transluminal septal myocardial ablation (PTSMA) provide prognostic information regarding the response to PTSMA in patients with drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). Background: Plasma BNP levels are associated with clinical outcomes in patients with HOCM. However, the prognostic value of plasma BNP level changes before and after PTSMA remains unclear...
2018: Open Heart
https://www.readbyqxmd.com/read/29763629/ventricular-pro-arrhythmic-phenotype-arrhythmic-substrate-ageing-and-mitochondrial-dysfunction-in-peroxisome-proliferator-activated-receptor-%C3%AE-coactivator-1%C3%AE-deficient-pgc-1%C3%AE-murine-hearts
#7
Shiraz Ahmad, Haseeb Valli, Karan R Chadda, James Cranley, Kamalan Jeevaratnam, Christopher L-H Huang
INTRODUCTION: Ageing and age-related bioenergetic conditions including obesity, diabetes mellitus and heart failure constitute clinical ventricular arrhythmic risk factors. MATERIALS AND METHODS: Pro-arrhythmic properties in electrocardiographic and intracellular recordings were compared in young and aged, peroxisome proliferator-activated receptor-γ coactivator-1β knockout (Pgc-1β-/- ) and wild type (WT), Langendorff-perfused murine hearts, during regular and programmed stimulation (PES), comparing results by two-way ANOVA...
May 12, 2018: Mechanisms of Ageing and Development
https://www.readbyqxmd.com/read/29762841/assessment-of-left-ventricular-systolic-synchrony-and-cardiac-function-in-patients-with-ischemic-heart-disease-by-echocardiography
#8
H-P Qu, P-S Dong, Y-J Song, H-M Wang
OBJECTIVE: To investigate the correlation between left ventricular systolic synchrony and cardiac function in patients with ischemic heart diseases of different degrees by echocardiography. PATIENTS AND METHODS: 84 cases of patients with ischemic heart diseases were consecutively selected including 28 cases of asymptomatic heart failure, 40 cases of mild to moderate heart failure, and 16 cases of severe and refractory heart failure. Interventricular synchrony was evaluated by echocardiography, and the result was expressed by interventricular mechanical delay (IVMD)...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29754812/a-randomized-controlled-trial-to-evaluate-the-safety-and-efficacy-of-cardiac-contractility-modulation
#9
William T Abraham, Karl-Heinz Kuck, Rochelle L Goldsmith, JoAnn Lindenfeld, Vivek Y Reddy, Peter E Carson, Douglas L Mann, Benjamin Saville, Helen Parise, Rodrigo Chan, Phi Wiegn, Jeffrey L Hastings, Andrew J Kaplan, Frank Edelmann, Lars Luthje, Rami Kahwash, Gery F Tomassoni, David D Gutterman, Angela Stagg, Daniel Burkhoff, Gerd Hasenfuß
OBJECTIVES: The authors sought to confirm a subgroup analysis of the prior FIX-HF-5 (Evaluate Safety and Efficacy of the OPTIMIZER System in Subjects With Moderate-to-Severe Heart Failure) study showing that cardiac contractility modulation (CCM) improved exercise tolerance (ET) and quality of life in patients with ejection fractions between 25% and 45%. BACKGROUND: CCM therapy for New York Heart Association (NYHA) functional class III and IV heart failure (HF) patients consists of nonexcitatory electrical signals delivered to the heart during the absolute refractory period...
May 5, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29746258/gi-bleeding-during-cf-lvad-support-state-of-the-field
#10
Rachna Kataria, Ulrich P Jorde
Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly used for the management of advanced heart failure refractory to optimal medical therapy. Despite the encouraging outcomes with CF-LVADs, gastrointestinal bleeding (GIB) continues to be a rather concerning complication resulting in increased rates of readmission and increased morbidity. The exact pathophysiology of CF-LVAD associated GIB remains poorly understood and this lack of knowledge limits our ability to control this morbid complication...
May 9, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29721672/outcomes-of-patients-requiring-extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-implantation-a-clinical-case-series
#11
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Itaru Takamisawa, Jun Shimizu, Nobuo Iguchi, Shuichiro Takanashi, Morimasa Takayama, Mitsuaki Isobe
Transcatheter aortic valve implantation (TAVI) has been established as a low-invasive therapy for aortic stenosis, but circulatory collapse necessitating mechanical circulatory support could occur during TAVI due to procedure itself or procedural complications. The purpose of this study is to describe the outcomes of patients requiring extracorporeal membrane oxygenation (ECMO) in TAVI. Among 384 consecutive patients undergoing TAVI from April 2010 to July 2017 in Sakakibara Heart Institute, we evaluated seven patients (1...
May 2, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#12
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29695659/effects-and-safety-of-sodium-glucose-cotransporter-2-inhibitors-in-diabetes-patients-with-drug-refractory-advanced-heart-failure
#13
Yoshihiro Seo, Masayoshi Yamamoto, Tomoko Machino-Ohtsuka, Tomoko Ishizu, Kazutaka Aonuma
BACKGROUND: This study aimed to investigate the effect and safety of sodium glucose cotransporter 2 inhibitors (SGLT2-Is) in patients with drug-refractory heart failure (HF).Methods and Results:In 12 diabetic patients with advanced HF, SGLT2-Is were added to the treatment regimen. At 6 months after administration, improvements in New York Heart Association class and reduction in B-type natriuretic peptide levels were observed, in particular in patients with high right atrial pressure...
April 24, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29687159/the-effects-of-tolvaptan-dose-on-cardiac-mortality-in-patients-with-acute-decompensated-heart-failure-after-hospital-discharge
#14
Kenji Matsumoto, Shoichi Ehara, Yasuhiro Nakamura, Keiko Otsuka, Yoshio Kawase
Tolvaptan (TLV) is a newly developed oral vasopressin-2 receptor antagonist that is mostly used for patients with acute decompensated heart failure (ADHF) refractory to conventional diuretic therapy. The aim of this study was to investigate the effects of outpatient TLV dose on cardiac mortality in patients discharged after hospitalization for ADHF. One hundred and five patients with ADHF who had been treated with TLV for the first time during hospitalization were retrospectively divided into three groups based on outpatient TLV use and dose...
April 23, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29675620/management-of-anemia-in-low-risk-myelodysplastic-syndromes-treated-with-erythropoiesis-stimulating-agents-newer-and-older-agents
#15
REVIEW
Roberto Castelli, Riccardo Schiavon, Valentina Rossi, Giorgio Lambertenghi Deliliers
The myelodysplastic syndromes (MDSs) are clonal hematopoietic stem cell disorders. The International Prognostic Score System (IPSS) groups MDS in lower-risk (IPSS low and intermediate-1) and higher-risk disease (IPSS intermediate-2 and high). AML transformation is the main concern in higher-risk MDS, while anemia and transfusion dependency represent the major issues for low-risk MDS patients. Improving erythropoiesis, and eliminating fatigue and symptoms, is the main therapeutic goal for low-risk MDS patients...
April 19, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29666358/revisiting-atrioventricular-nodal-ablation-and-cardiac-pacing-of-atrial-fibrillation-in-a-patient-with-dextrocardia
#16
Munish Sharma, Ritesh Neupane, Koroush Khalighi
BACKGROUND Poorly controlled ventricular rate associated with atrial fibrillation (AF) leads to tachycardia-induced left ventricular dysfunction. Atrioventricular (AV) nodal ablation and cardiac pacing is the standard of care in refractory congestive heart failure (CHF) due to AF with moderate to rapid ventricular response that failed conventional medical therapy. If the patient is not a candidate for AF ablation with pulmonary vein isolation and elimination of AF foci, this is an effective approach, but it does have some challenges when done in a patient with dextrocardia and situs inversus...
April 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29665203/tolvaptan-alleviates-excessive-fluid-retention-of-nephrotic-diabetic-renal-failure-unresponsive-to-furosemide
#17
Tesshu Takada, Tsuguto Masaki, Ayako Hoshiyama, Takuya Toki, Yuji Kamata, Masayoshi Shichiri
Patients with diabetic nephropathy develop nephrotic syndrome, and may show limited response to conventional therapy. They often require earlier initiation of renal replacement therapy because they become refractory to diuretics, and experience excessive fluid retention. We aimed to investigate the efficacy of tolvaptan, an oral arginine vasopressin type 2 receptor antagonist, in a case series of 14 severe diabetic renal failure patients who were severely refractory to maximal doses of furosemide and had excessive fluid retention despite preserved cardiac function and residual renal function...
April 17, 2018: Nephrology
https://www.readbyqxmd.com/read/29663677/the-carotid-sinus-nerve-structure-function-and-clinical-implications
#18
Andrea Porzionato, Veronica Macchi, Carla Stecco, Raffaele De Caro
Interest has been renewed in the anatomy and physiology of the carotid sinus nerve (CSN) and its targets (carotid sinus and carotid body, CB), due to recent proposals of surgical procedures for a series of common pathologies, such as carotid sinus syndrome, hypertension, heart failure, and insulin resistance. The CSN originates from the glossopharyngeal nerve soon after its appearance from the jugular foramen. It shows frequent communications with the sympathetic trunk (usually at the level of the superior cervical ganglion) and the vagal nerve (main trunk, pharyngeal branches, or superior laryngeal nerve)...
April 16, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/29655822/clinical-spectrum-and-management-of-heart-failure-in-hypertrophic-cardiomyopathy
#19
REVIEW
Barry J Maron, Ethan J Rowin, James E Udelson, Martin S Maron
Heart failure (HF), characterized by excessive exertional dyspnea, is a common complication within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). HF has become an increasingly prominent management issue with the reduction in sudden deaths due to use of implantable defibrillators in this disease. Exertional dyspnea ranges in severity from mild to severe (New York Heart Association functional classes II to IV) and not uncommonly becomes refractory to medical management, leading to progressive disability, but largely in the absence of pulmonary congestion and volume overload requiring hospitalization...
May 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29643259/cerebrovascular-accidents-during-mechanical-circulatory-support-new-predictors-of-ischemic-and-hemorrhagic-strokes-and-outcome
#20
Saef Izzy, Daniel B Rubin, Firas S Ahmed, Feras Akbik, Simone Renault, Katelyn W Sylvester, Henrikas Vaitkevicius, Jennifer A Smallwood, Michael M Givertz, Steven K Feske
BACKGROUND AND PURPOSE: Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality...
May 2018: Stroke; a Journal of Cerebral Circulation
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