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Refractory heart failure

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https://www.readbyqxmd.com/read/28649486/constrictive-pericarditis-induced-shunting-through-a-pfo-persistence-despite-pericardiectomy
#1
Emily Schuiteman, Thomas Verrill, Nader Mina, Bhavinkumar Dalal
A patent foramen ovale (PFO) is found in around 25-30% of patients. The discovery is often made only on autopsy, as most PFOs are clinically silent and any inter-atrial blood exchange typically shunts from the left to right heart [1]. Thus, when a patient presents with hypoxic respiratory failure, concern for presence of a PFO is rarely at the top of the differential. However, in the setting of elevated right heart pressures, PFOs can become of great hemodynamic importance and can lead to deadly complications, including right to left shunting and refractory hypoxic respiratory failure...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28643428/mechanical-circulatory-support-in-the-treatment-of-advanced-heart-failure
#2
Amanda W Cai, Sabrina Islam, Shelley R Hankins, Wade Fischer, Howard J Eisen
According to the Centers for Disease Control (CDC), heart failure (HF) remains a pervasive condition with high morbidity and mortality, affecting 5.8 million people in the United States (US) and 23 million worldwide. For patients with refractory end-stage HF, heart transplantation is the gold standard for definitive treatment. However, the demand for heart transplantation has consistently exceeded the availability of donor hearts, with approximately 2,331 orthotopic heart transplantations performed in the US in 2015 despite an estimated 100,000 to 250,000 patients with New York Heart Association (NYHA) class IIIB or IV symptoms that are refractory to medical treatment and potential transplant candidates...
June 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28641796/cardiac-sympathetic-denervation-for-refractory-ventricular-arrhythmias
#3
Marmar Vaseghi, Parag Barwad, Federico J Malavassi Corrales, Harikrishna Tandri, Nilesh Mathuria, Rushil Shah, Julie M Sorg, Jean Gima, Kaushik Mandal, Luis C Sàenz Morales, Yash Lokhandwala, Kalyanam Shivkumar
BACKGROUND: Cardiac sympathetic denervation (CSD) has been shown to reduce the burden of implantable cardioverter-defibrillator (ICD) shocks in small series of patients with structural heart disease (SHD) and recurrent ventricular tachyarrhythmias (VT). OBJECTIVES: This study assessed the value of CSD and the characteristics associated with outcomes in this population. METHODS: Patients with SHD who underwent CSD for refractory VT or VT storm at 5 international centers were analyzed by the International Cardiac Sympathetic Denervation Collaborative Group...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28627809/ivabradine-reduces-digitalis-induced-ventricular-arrhythmias
#4
Gerrit Frommeyer, Jan Weller, Christian Ellermann, Nils Bögeholz, Patrick Leitz, Dirk G Dechering, Simon Kochhäuser, Kristina Wasmer, Lars Eckardt
The I(f) channel inhibitor ivabradine is recommended for treatment of heart failure but also affects potassium currents and thereby prolongs ventricular repolarization. The aim of the present study was to examine the electrophysiological effects of ivabradine on digitalis-induced ventricular arrhythmias. Thirteen rabbit hearts were isolated and Langendorff-perfused. After obtaining baseline data, the digitalis glycoside ouabain was infused (0.2μM). Monophasic action potentials and ECG showed a significant abbreviation of QT interval (-34ms,p<0...
June 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28614216/refractory-adult-onset-still-disease-complicated-by-macrophage-activation-syndrome-and-acute-myocarditis-a-case-report-treated-with-high-doses-8%C3%A2-mg-kg-d-of-anakinra
#5
Federico Parisi, Annamaria Paglionico, Valentina Varriano, Gianfranco Ferraccioli, Elisa Gremese
RATIONALE: Myocarditis is a rare but potentially fatal complication of Still's disease (about 7% of total cases). PATIENT CONCERNS: A 42-year-old woman was admitted to our ward with high-grade fever, rash and polyarthralgia, lasting since 4 weeks and rapidly complicated by MAS and acute heart failure. DIAGNOSES: Adult Onset Still's Disease rapidly developping macrophage activation syndrome and disseminated intravascular coagulopathy, further complicated by iperacute myocarditis with cardiac arrest...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28612155/the-role-of-spatial-organization-of-ca-2-release-sites-in-the-generation-of-arrhythmogenic-diastolic-ca-2-release-in-myocytes-from-failing-hearts
#6
Andriy E Belevych, Hsiang-Ting Ho, Ingrid M Bonilla, Radmila Terentyeva, Karsten E Schober, Dmitry Terentyev, Cynthia A Carnes, Sándor Györke
In heart failure (HF), dysregulated cardiac ryanodine receptors (RyR2) contribute to the generation of diastolic Ca(2+) waves (DCWs), thereby predisposing adrenergically stressed failing hearts to life-threatening arrhythmias. However, the specific cellular, subcellular, and molecular defects that account for cardiac arrhythmia in HF remain to be elucidated. Patch-clamp techniques and confocal Ca(2+) imaging were applied to study spatially defined Ca(2+) handling in ventricular myocytes isolated from normal (control) and failing canine hearts...
July 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28604846/identification-of-active-components-in-yixinshu-capsule-with-protective-effects-against-myocardial-dysfunction-on-human-induced-pluripotent-stem-cell-derived-cardiomyocytes-by-an-integrative-approach
#7
Minyu Zhang, Hongwei Wu, Feifei Guo, Yangyang Yu, Junying Wei, Ya Geng, Shifeng Wang, Shiyou Li, Hongjun Yang
Traditional Chinese medicine (TCM) preparations have significant effects on some refractory diseases; however, these compositions are complex and their mechanisms are unknown. Identification of the active components in these preparations is essential. The mortality rate for heart failure (HF) has been increasing in recent years, and myocardial dysfunction (MD) has been proved to be the pathological basis of HF. Yixinshu Capsule (YXSC) is a multi-component oral drug with therapeutic effects on HF. However, the key active components are still unclear...
June 12, 2017: Molecular BioSystems
https://www.readbyqxmd.com/read/28602672/surgical-and-hybrid-ablation-of-atrial-fibrillation
#8
REVIEW
Reece A Davies, Saurabh Kumar, Richard B Chard, Stuart P Thomas
Atrial fibrillation (AF) is the most common arrhythmia in humans and is known to be associated with an increased risk of stroke, dementia, heart failure and mortality. Non-pharmacological therapy with ablation using either surgical or percutaneous techniques is recommended in drug refractory AF. Early attempts to devise procedures to ablate AF and restore sinus rhythm culminated with the Cox-Maze procedure, the first truly successful procedure. Since then, ablation surgery has been conducted predominately as a concomitant procedure...
May 18, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28600096/alcohol-septal-ablation-to-reduce-heart-failure
#9
REVIEW
Joshua McKay, Sherif F Nagueh
Hypertrophic cardiomyopathy is a commonly encountered inheritable cardiac disorder with variable phenotypic expression. Although most patients will have no or mild symptoms, 10% will develop heart failure symptoms refractory to medical management. This article discusses the mechanisms through which hypertrophic cardiomyopathy induces heart failure and how alcohol septal ablation can reverse each of these mechanisms to lead to clinical improvement.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28597998/a-novel-mechanical-mitral-valve-replacement-using-sapien-xt
#10
Megan Koehle, Justin A Strote, Mark Guadagnoli, J Bradley Oldemeyer
PATIENT PRESENTATION: We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. EVALUATION AND MANAGEMENT: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure...
June 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28592753/recent-surgical-results-for-active-endocarditis-complicated-with-perivalvular-abscess
#11
Daisuke Yoshioka, Koichi Toda, Jun-Ya Yokoyama, Ryohei Matsuura, Shigeru Miyagawa, Yukitoshi Shirakawa, Toshiki Takahashi, Taichi Sakaguchi, Hirotsugu Fukuda, Yoshiki Sawa
BACKGROUND: Surgical treatment for endocarditis patients with a perivalvular abscess is still challenging.Methods and Results:From 2009 to 2016, 470 patients underwent surgery for active endocarditis at 11 hospitals. Of these, 226 patients underwent aortic valve surgery. We compared the clinical results of 162 patients without a perivalvular abscess, 37 patients who required patch reconstruction of the aortic annulus (PR group) and 27 who underwent aortic root replacement (ARR group)...
June 8, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28591324/case-2-2017-56-year-old-male-with-refractory-heart-failure-systemic-arterial-hypertension-and-aortic-valve-stenosis-that-led-to-heart-transplantation
#12
Desidério Favarato, Paulo Sampaio Gutierrez
No abstract text is available yet for this article.
May 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28559663/consecutive-sessions-of-rescue-balloon-atrial-septostomy-for-an-idiopathic-pulmonary-arterial-hypertension-patient-with-refractory-right-heart-failure-usefulness-of-intracardiac-echocardiography-guidance
#13
Yu-Wei Chen, Hung-Chih Pan, Kuo-Yang Wang, Kae-Woei Liang
For idiopathic pulmonary artery hypertension (PAH) patients with end-stage right heart failure who received maximal medical therapy, balloon atrial septostomy (BAS) is recommended by most guidelines as a palliative therapy or a bridging treatment before lung transplantation. In this report, we described a 32-year-old woman with idiopathic PAH, who received maximal PAH-specific medical treatment, including intravenous prostacyclin, but still suffered from refractory right heart failure. The markedly enlarged right atrium (RA), high mean RA pressure of 23 mmHg, low systemic arterial oxygen saturation of 86% and concomitant pancytopenia all increased the patient's risk for BAS...
May 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28556923/antiarrhythmic-properties-of-ivabradine-in-an-experimental-model-of-short-qt-syndrome
#14
Gerrit Frommeyer, Jan Weller, Christian Ellermann, Sven Kaese, Simon Kochhäuser, Philipp S Lange, Dirk G Dechering, Lars Eckardt
The If channel inhibitor ivabradine is recommended for treatment of chronic heart failure. However, ivabradine also inhibits human ether-a-go-go (hERG) mediated potassium currents. The aim of the present study was to assess the electrophysiologic effects of ivabradine in an experimental model of short-QT-syndrome. 12 rabbit hearts were isolated and Langendorff-perfused. After obtaining baseline data, pinacidil, an IK-ATP channel opener, was infused (1μM). Eight endo- and epicardial monophasic action potentials and a 12-lead ECG showed a significant abbreviation of QT interval (-32ms,p<0...
May 29, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28555387/ameliorating-the-severity-of-sleep-disordered-breathing-concomitant-with-heart-failure-status-after-percutaneous-transluminal-septal-myocardial-ablation-for-drug-refractory-hypertrophic-obstructive-cardiomyopathy
#15
Keitaro Akita, Yuichiro Maekawa, Takashi Kohno, Hikaru Tsuruta, Mitsushige Murata, Keiichi Fukuda
The coexistence of sleep-disordered breathing (SDB) and hypertrophic obstructive cardiomyopathy (HOCM) has widely been recognized; however, the impact of percutaneous transluminal septal myocardial ablation (PTSMA) for HOCM on SDB remains unknown. Herein, we examine cardiorespiratory polygraph parameters in patients with drug-refractory HOCM before and after PTSMA. Forty consecutive drug-refractory HOCM patients, admitted to Keio University Hospital, and who underwent cardiorespiratory polygraphy were retrospectively analyzed...
May 29, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28551597/clozapine-re-exposure-after-dilated-cardiomyopathy
#16
Mariëtte Nederlof, Theo Wj Benschop, Cornelia Adriana de Vries Feyens, Eibert Roelof Heerdink
A 63-year-old woman with diabetes type II and a history of breast cancer was treated with clozapine for her refractory schizophrenia. She developed a dilated cardiomyopathy with an ejection fraction of 25%, a life-threatening event. The cause of heart failure could be multifactorial, with clozapine, family history, chemotherapy, diabetes type II and/or lithium as possible contributing risk factors. Clozapine was discontinued and the patient was referred to a hospice. Two weeks later, her heart failure slowly improved...
May 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28549671/the-outcome-of-extracorporeal-life-support-after-general-thoracic-surgery-timing-of-application
#17
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
#18
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
#19
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
#20
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
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