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Refractory heart failure

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https://www.readbyqxmd.com/read/28549671/the-outcome-of-extracorporeal-life-support-after-general-thoracic-surgery-timing-of-application
#1
Heemoon Lee, Yang Hyun Cho, Hyoung Woo Chang, Ji-Hyuk Yang, Jong Ho Cho, Kiick Sung, Young Tak Lee
BACKGROUND: Extracorporeal life support (ECLS) is widely used in refractory cardiac or pulmonary failure. Because complications of general thoracic surgery frequently involve the heart or lungs, ECLS can be a useful option. Therefore, we retrospectively reviewed our experience with ECLS after general thoracic surgery. METHODS: There were 17,185 adult general thoracic surgery procedures between 2005 and 2013 at our institution, including resection of the lung (n = 10,434; 60...
May 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28545407/cryoballoon-vs-open-irrigated-radiofrequency-ablation-for-paroxysmal-atrial-fibrillation-long-term-freezeaf-outcomes
#2
Armin Luik, Kevin Kunzmann, Patrick Hörmann, Kerstin Schmidt, Andrea Radzewitz, Peter Bramlage, Thomas Schenk, Gerhard Schymik, Matthias Merkel, Meinhard Kieser, Claus Schmitt
BACKGROUND: Effective treatment of paroxysmal atrial fibrillation (AF) is essential for reducing the risk of stroke and heart failure. Cryoballoon (CB) ablation has been developed as an alternative to the use of radiofrequency (RF) energy for electrical isolation of the pulmonary veins. Herein, we provide long-term data regarding the efficacy of CB ablation in comparison to RF. METHODS: FreezeAF was a randomised non-inferiority study comparing CB ablation with RF ablation for the treatment of patients with drug-refractory paroxysmal AF...
May 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28523319/amyloidosis-a-rare-cause-of-refractory-heart-failure-in-a-young-female
#3
Irina Iuliana Costache, Claudia Florida Costea, Mihai Danciu, Victor Vlad Costan, Viviana Aursulesei, Gabriela FlorenŢa Dumitrescu, Mihaela Dana Turliuc, Anca Sava
Cardiac amyloidosis may occur in any type of systemic amyloidosis. The clinical picture is often characterized by restrictive cardiomyopathy. We report the case of a 41-year-old female patient admitted to the Department of Cardiology with clinical signs of right heart failure: congested jugular veins, hepatomegaly, peripheral edema, ascites associated with atrial fibrillation, low values of arterial blood pressure and oliguria. Echocardiographic findings were helpful for the diagnosis of cardiac amyloidosis: enlarged atrial cavities, normal size ventricles, thickened ventricular septum and posterior left ventricle wall with normal left ventricular ejection fraction, mitral and tricuspid regurgitation...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28496031/atrial-septostomy-for-left-atrial-decompression-during-extracorporeal-membrane-oxygenation-by-inoue-balloon-catheter
#4
Yen-Nien Lin, Yin-Huei Chen, Huang-Joe Wang, Jui-Sung Hung, Kuan-Cheng Chang, Ping-Han Lo
BACKGROUND: Refractory pulmonary edema is an infrequent but serious complication in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for myocardial failure. Left atrial (LA) decompression in this setting is important. Although a few methods have been reported, the experience is mostly limited to children. We aimed to evaluate the feasibility of Inoue balloon catheter in percutaneous trans-septal LA decompression in adult cardiogenic patients.Methods and Results:We retrospectively analyzed 16 procedures of trans-septal LA decompression by Inoue balloon catheter in 15 VA-ECMO patients (aged 22-65 years, 6 men) with refractory pulmonary edema from May 2012 to December 2014...
May 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28489648/clinical-experience-with-iv-angiotensin-ii-administration-a-systematic-review-of-safety
#5
Laurence W Busse, Xueyuan Shelly Wang, Divya M Chalikonda, Kevin W Finkel, Ashish K Khanna, Harold M Szerlip, David Yoo, Sharon L Dana, Lakhmir S Chawla
OBJECTIVE: Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. This is a systematic review of the safety of IV angiotensin II. DATA SOURCES: PubMed, Medline, Scopus, and Cochrane. STUDY SELECTION: Studies in which human subjects received IV angiotensin II were selected whether or not safety was discussed. DATA EXTRACTION: In total, 18,468 studies were screened by two reviewers and one arbiter...
May 9, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28483204/usefulness-of-non-anteroseptal-region-left-ventricular-hypertrophy-using-cardiac-magnetic-resonance-to-predict-repeat-alcohol-septal-ablation-for-refractory-obstructive-hypertrophic-cardiomyopathy
#6
Mitsunobu Kitamura, Yasuo Amano, Morimasa Takayama, Junsuke Shibuya, Junya Matsuda, Hideto Sangen, Shunichi Nakamura, Hitoshi Takano, Kuniya Asai, Shinichiro Kumita, Wataru Shimizu
We evaluated a cohort of patients treated with alcohol septal ablation (ASA) to identify predictive factors for repeat ASA. We compared 15 patients who underwent repeat ASA procedures (group R) with 69 patients not requiring repeat procedures (group S) in terms of clinical parameters and morphologic cardiac magnetic resonance. Group R showed higher number of hypertrophic segments (thickness ≥15 mm) in the basal left ventricular level (2.8 ± 1.7 vs 1.7 ± 0.8, p = 0.009) than group S. In the multivariate analysis, diuretics use (adjusted odds ratio 5...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28470920/a-rationale-for-early-extracorporeal-membrane-oxygenation-in-patients-with-postinfarction-ventricular-septal-rupture-complicated-by-cardiogenic-shock
#7
Daniel Rob, Rudolf Špunda, Jaroslav Lindner, Vilém Rohn, Jan Kunstýř, Martin Balík, Jan Rulíšek, Petr Kopecký, Michal Lipš, Ondřej Šmíd, Tomáš Kovárník, František Mlejnský, Aleš Linhart, Jan Bělohlávek
AIMS: Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470918/isolated-left-ventricular-failure-is-a-predictor-of-poor-outcome-in-patients-receiving-veno-arterial-extracorporeal-membrane-oxygenation
#8
Corstiaan A den Uil, Lucia S Jewbali, Martijn J Heeren, Alina A Constantinescu, Nicolas M Van Mieghem, Dinis Dos Reis Miranda
AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28466536/a-retrospective-analysis-of-3954-patients-in-phase-2-3-trials-of-bortezomib-for-the-treatment-of-multiple-myeloma-towards-providing-a-benchmark-for-the-cardiac-safety-profile-of-proteasome-inhibition-in-multiple-myeloma
#9
Jacob P Laubach, Javid J Moslehi, Sanjeev A Francis, Jesús F San Miguel, Pieter Sonneveld, Robert Z Orlowski, Philippe Moreau, Laura Rosiñol, Edward A Faber, Peter Voorhees, Maria-Victoria Mateos, Loreta Marquez, Huaibao Feng, Avinash Desai, Helgi van de Velde, Jennifer Elliott, Hongliang Shi, Edward Dow, Nishith Jobanputra, Dixie-Lee Esseltine, Liviu Niculescu, Kenneth C Anderson, Sagar Lonial, Paul G Richardson
This retrospective analysis aimed to establish the overall cardiac safety profile of bortezomib using patient-level data from one phase 2 and seven phase 3 studies in previously untreated and relapsed/refractory multiple myeloma (MM). Seven clinically relevant primary [congestive heart failure (CHF), arrhythmias, ischaemic heart disease (IHD), cardiac death] and secondary (hypertension, dyspnoea, oedema) cardiac endpoints were defined based on MedDRA v16.0 preferred terms. 2509 bortezomib-treated patients and 1445 patients in non-bortezomib-based control arms were included...
May 3, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#10
Manish Patel, Khashayar K Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, Igor D Gregoric
Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28458893/successful-treatment-of-thyroid-storm-presenting-as-recurrent-cardiac-arrest-and-subsequent-multiorgan-failure-by-continuous-renal-replacement-therapy
#11
Han Soo Park, Su Kyoung Kwon, Ye Na Kim
SUMMARY: Thyroid storm is a rare and potentially life-threatening medical emergency. We experienced a case of thyroid storm associated with sepsis caused by pneumonia, which had a catastrophic course including recurrent cardiac arrest and subsequent multiple organ failure (MOF). A 22-year-old female patient with a 10-year history of Graves' disease was transferred to our emergency department (ED). She had a cardiac arrest at her home and a second cardiac arrest at the ED. Her heart recovered after 20 min of cardiac resuscitation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28451449/benefit-of-tolvaptan-in-the-management-of-hyponatraemia-in-patients-with-diuretic-refractory-congestive-heart-failure-the-semi-sec-project
#12
Antonio Pose, Luis Almenar, Juan José Gavira, Amador López-Granados, Teresa Blasco, Juan Delgado, Oscar Aramburu, Avelino Rodríguez, Luis Manzano, Nicolás Manito
AIMS: Hyponatraemia is an electrolyte disorder that occurs in advanced congestive heart failure (HF) and worsens prognosis. We explored the usefulness of tolvaptan, which has shown promising results in the treatment of this condition. METHODS AND RESULTS: This study is based on a retrospective national registry (2011-15) of patients hospitalized with refractory HF and hyponatraemia who agreed to receive tolvaptan when standard treatment was ineffective. The benefit of tolvaptan was analysed according to the following criteria: normalization ([Na(+)] ≥ 135 mmol/L) or increased sodium levels [Na(+)] ≥ 4 mEq/L on completion of treatment, and increase in urine output by 300 or 500 mL at 48 h...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28451448/quality-of-life-and-long-term-mortality-in-patients-with-advanced-chronic-heart-failure-treated-with-intermittent-low-dose-intravenous-inotropes-in-an-outpatient-setting
#13
Fernando Chernomordik, Dov Freimark, Michael Arad, Michael Shechter, Shlomi Matetzky, Yulia Savir, Nir Shlomo, Amir Peled, Ilan Goldenberg, Yael Peled
AIMS: There are limited data on the effect of low-dose, intermittent inotropic therapy in an outpatient setting on the quality of life (QOL) in patients with advanced refractory heart failure (HF) symptoms. We aimed to analyse the effect of this treatment modality on QOL and subsequent survival. METHODS AND RESULTS: The study population comprised 287 consecutive patients with advanced refractory HF symptoms who were treated with low-dose, intravenous intermittent inotropic therapy in the HF Day Care Service at Sheba Medical Centre between September 2000 and September 2012...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28444174/catheter-ablation-for-ventricular-tachycardia-in-patients-with-cardiac-sarcoidosis-a-systematic-review
#14
Nikolaos Papageorgiou, Rui Providência, Konstantinos Bronis, Dirk G Dechering, Neil Srinivasan, Lars Eckardt, Pier D Lambiase
Aims: Cardiac sarcoidosis (CS) is associated with a poor prognosis. Important features of CS include heart failure, conduction abnormalities, and ventricular arrhythmias. Ventricular tachycardia (VT) is often refractory to antiarrhythmic drugs (AAD) and immunosuppression. Catheter ablation has emerged as a treatment option for recurrent VT. However, data on the efficacy and outcomes of VT ablation in this context are sparse. Methods and results: A systematic search was performed on PubMed, EMBASE, and Cochrane database (from inception to September 2016) with included studies providing a minimum of information on CS patients undergoing VT ablation: age, gender, VT cycle length, CS diagnosis criteria, and baseline medications...
April 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28426455/digoxin-attenuates-murine-experimental-colitis-by-downregulating-th17-related-cytokines
#15
Shinya Tani, Ryosuke Takano, Satoshi Tamura, Shinji Oishi, Moriya Iwaizumi, Yasushi Hamaya, Kosuke Takagaki, Toshi Nagata, Shintaro Seto, Toshinobu Horii, Isao Kosugi, Toshihide Iwashita, Satoshi Osawa, Takahisa Furuta, Hiroaki Miyajima, Ken Sugimoto
BACKGROUND: Digoxin, a cardiac glycoside used for the treatment of heart failure, was reported to inhibit the retinoid-related orphan receptor gamma t (RORγt) and attenuate the severity of experimental autoimmune encephalomyelitis and arthritis in mice. However, the effects of digoxin in a mice model of inflammatory bowel disease have not been elucidated. METHODS: Colitis was induced in severe combined immunodeficiency mice by adoptive transfer of CD45RB CD4 T cells...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28409501/successful-treatment-of-fulminant-lyme-myocarditis-with-mechanical-circulatory-support-in-a-young-male-adult-a-case-report
#16
Željko Župan, Dino Mijatović, Igor Medved, Snježana Kraljić, Jurica Juranić, Berislav Barbalić, Marin Oštrić
We describe the case of fulminant myocarditis due to Lyme disease and use of mechanical circulatory support (MCS) for the treatment of the Lyme carditis associated with refractory cardiogenic shock. Fulminant Lyme myocarditis in young adult male patient led to a sudden onset of acute, severe biventricular heart failure with progressive cardiogenic shock, and multiorgan failure immediately after admission.
April 14, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/28405091/ambulatory-extracorporeal-membrane-oxygenation-with-subclavian-venoarterial-cannulation-to-increase-mobility-and-recovery-in-a-patient-awaiting-cardiac-transplantation
#17
Samuel Jacob, Juan C MacHannaford, Themistokles Chamogeorgakis, Gonzalo V Gonzalez-Stawinski, Joost Felius, Aldo E Rafael, Rajasekhar S Malyala, Brian Lima
Venoarterial extracorporeal membrane oxygenation (ECMO) can provide temporary cardiopulmonary support for patients in hemodynamic extremis or refractory heart failure until more durable therapies-such as cardiac transplantation or a left ventricular assist device-can be safely implemented. Conventional ECMO cannulation strategies commonly employ the femoral artery and vein, constraining the patients to the supine position for the duration of ECMO support. We have recently adopted a modified cannulation approach to promote patient mobility, rehabilitation, and faster recovery and to mitigate complications associated with femoral arterial cannulation, such as limb ischemia and compartment syndrome...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28400731/il-1-inhibition-may-have-an-important-role-in-treating-refractory-kawasaki-disease
#18
REVIEW
Perrine Dusser, Isabelle Koné-Paut
Kawasaki disease (KD) is an acute inflammatory vasculitis occurring in young children before 5 years and representing at this age, the main cause of acquired heart disease. A single infusion of 2 g/kg of intravenous immunoglobulins along with aspirin has reduced the frequency of coronary artery aneurysms from 25 to 5%. However, 10-20% of patients do not respond to standard treatment and have an increased risk of cardiac complications and death. The development of more potent therapeutic approaches of KD is an urgent need...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28396172/role-of-suppression-of-the-inward-rectifier-current-in-terminal-action-potential-repolarization-in-the-failing-heart
#19
Michael G Klein, Matie Shou, Jayna Stohlman, Soroosh Solhjoo, Myles Haigney, Richard R Tidwell, Robert E Goldstein, Thomas P Flagg, Mark C Haigney
BACKGROUND: The failing heart exhibits an increased arrhythmia susceptibility that is often attributed to action potential (AP) prolongation due to significant ion channel remodeling. The inwardly rectifying K(+) current (IK1) has been reported to be reduced, but its contribution to shaping the AP waveform and cell excitability in the failing heart remains unclear. OBJECTIVE: The purpose of this study was to define the effect of IK1 suppression on the cardiac AP and excitability in the normal and failing hearts...
April 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28396164/dose-escalation-of-total-marrow-irradiation-in-high-risk-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#20
Susanta Hui, Claudio Brunstein, Yutaka Takahashi, Todd DeFor, Shernan G Holtan, Veronika Bachanova, Christopher Wilke, Darren Zuro, Celalettin Ustun, Daniel Weisdorf, Kathryn Dusenbery, Michael R Verneris
Patients with refractory leukemia or minimal residual disease (MRD) at transplantation are at increased risk of relapse. Augmentation of irradiation, especially to sites of disease (ie, bone marrow) is one potential strategy for overcoming this risk. We studied the feasibility of radiation dose escalation in high-risk patients using total marrow irradiation (TMI) in a phase I dose-escalation trial. Four pediatric and 8 adult patients received conditioning with cyclophosphamide and fludarabine in conjunction with image-guided radiation to the bone marrow at 15 Gy and 18 Gy (in 3-Gy fractions), while maintaining the total body irradiation (TBI) dose to the vital organs (lungs, hearts, eyes, liver, and kidneys) at <13...
April 7, 2017: Biology of Blood and Marrow Transplantation
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