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Cardiac risk assessment

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https://www.readbyqxmd.com/read/29679768/comparison-of-proaqt-pulsioflex%C3%A2-and-oesophageal-doppler-for-intraoperative-haemodynamic-monitoring-during-intermediate-risk-abdominal-surgery
#1
Grégoire Weil, Cyrus Motamed, Alexandre Eghiaian, Xavier Monnet, Stéphanie Suria
OBJECTIVE: To compare cardiac index (CI) between Proaqt/PulsioFlex® and esophageal Doppler (OD) and the ability of the PulsioFlex® to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex® on the accuracy of the measured CI. METHODS: In a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex® before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120min)...
April 18, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29679599/mortality-in-pulmonary-arterial-hypertension-patients-treated-with-continuous-prostanoids
#2
S D Bartolome, N Sood, T S Shah, K Styrvoky, F T Torres, K M Chin
INTRODUCTION: Parenteral prostanoids are considered the treatment of choice for patients with severe pulmonary arterial hypertension (PAH). Prognostic studies for patients treated in the modern era are limited. METHODS: In this retrospective cohort study, patients initiating IV epoprostenol or IV or SC treprostinil therapy for PAH from 2007-2016 at UT Southwestern, Dallas, TX and Ohio State University, Columbus, OH were included. Transplant-free survival was assessed from the time of IV/SC initiation and from the time of first follow-up...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29679411/the-use-of-a-logistic-regression-model-to-develop-a-risk-assessment-of-intraoperatively-acquired-pressure-ulcer
#3
Ling Gao, Lina Yang, Xiaoqin Li, Jin Chen, Juan Du, Xiaoxia Bai, Xianjun Yang
AIMS AND OBJECTIVES: To screen the factors of intraoperatively acquired pressure ulcer (IAPU) and establish a new risk assessment model of IAPU. DESIGN: This is a prospective study. METHODS: A total of 1963 patients who received neurosurgery, orthopaedics, pediatric surgery and cardiac surgery therapy in Sichuan Academy of Medical Science and Provincial People's Hospital in China from October 2015 to October 2016 were enrolled in the study and their clinical parameters were collected...
April 20, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29678977/minimizing-icu-neurological-dysfunction-with-dexmedetomidine-induced-sleep-mindds-protocol-for-a-randomised-double-blind-parallel-arm-placebo-controlled-trial
#4
Kenneth T Shelton, Jason Qu, Federico Bilotta, Emery N Brown, Gaston Cudemus, David A D'Alessandro, Hao Deng, Alan DiBiasio, Jacob A Gitlin, Eunice Y Hahm, Lauren E Hobbs, Timothy T Houle, Reine Ibala, Marco Loggia, Kara J Pavone, Shahzad Shaefi, George Tolis, M Brandon Westover, Oluwaseun Akeju
INTRODUCTION: Delirium, which is prevalent in postcardiac surgical patients, is an acute brain dysfunction characterised by disturbances in attention, awareness and cognition not explained by a pre-existing neurocognitive disorder. The pathophysiology of delirium remains poorly understood. However, basic science and clinical studies suggest that sleep disturbance may be a modifiable risk factor for the development of delirium. Dexmedetomidine is a α-2A adrenergic receptor agonist medication that patterns the activity of various arousal nuclei similar to sleep...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678624/autonomic-cardiovascular-control-and-cardiac-arrhythmia-in-two-pregnant-women-with-hypertrophic-cardiomyopathy-insights-from-icd-monitoring
#5
Pietro Francia, Carmen Adduci, Beatrice Musumeci, Lorenzo Semprini, Francesca Palano, Luigi Zezza, Massimo Volpe, Camillo Autore
In women with hypertrophic cardiomyopathy (HCM), pregnancy prompts major changes in hemodynamic and cardiac autonomic function that may precipitate heart failure (HF) or increase the risk of cardiac arrhythmia. We report the clinical follow-up of two patients with non-obstructive HCM implanted with a cardioverter defibrillator (ICD) allowing for continuous analysis of heart rate (HR), heart rate variability (HRV) and cardiac arrhythmia throughout the entire course of pregnancy. Both patients experienced increased HR and decreased HRV from the early stages of pregnancy, which persisted until delivery...
April 17, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29678336/stress-myocardial-blood-flow-heterogeneity-is-a-positron-emission-tomography-biomarker-of-ventricular-arrhythmias-in-patients-with-hypertrophic-cardiomyopathy
#6
Dai-Yin Lu, Hulya Yalçin, Fatih Yalçin, Min Zhao, Sanjay Sivalokanathan, Ines Valenta, Abdel Tahari, Martin G Pomper, Theodore P Abraham, Thomas H Schindler, M Roselle Abraham
Patients with hypertrophic cardiomyopathy (HC) are at increased risk of sudden cardiac death. Abnormalities in myocardial blood flow (MBF) detected by positron emission tomography (PET) are common in HC, but a PET marker that identifies patients at risk of sudden cardiac death is lacking. We hypothesized that disparities in regional myocardial perfusion detected by PET would identify patients with HC at risk of ventricular arrhythmias. To test this hypothesis, we quantified global and regional MBFs by 13 NH3 -PET at rest and at stress, and developed a heterogeneity index to assess MBF heterogeneity in 133 symptomatic patients with HC...
February 6, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29678335/arrhythmic-risk-stratification-in-patients-with-idiopathic-dilated-cardiomyopathy
#7
Davide Stolfo, Nicole Ceschia, Massimo Zecchin, Antonio De Luca, Marco Gobbo, Giulia Barbati, Marta Gigli, Marco Masè, Bruno Pinamonti, Alberto Pivetta, Marco Merlo, Gianfranco Sinagra
Arrhythmic risk stratification in idiopathic dilated cardiomyopathy (IDC) remains a major concern. As the ventricles remodel in time, risk factors for arrhythmic death may change. A cohort of 710 patients with idiopathic dilated cardiomyopathy, without previous ventricular arrhythmias, was retrospectively studied to understand how risks vary in time. The primary end point was a composite of sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia, and appropriate implantable cardioverter-defibrillator interventions...
March 14, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29677630/resting-heart-rate-and-the-incidence-and-progression-of-valvular-calcium-the-multi-ethnic-study-of-atherosclerosis-mesa
#8
Kojo Amoakwa, Oluwaseun E Fashanu, Martin Tibuakuu, Di Zhao, Eliseo Guallar, Seamus P Whelton, Wesley T O'Neal, Wendy S Post, Matthew J Budoff, Erin D Michos
BACKGROUND AND AIMS: Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline...
April 6, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29677038/postoperative-b-type-natriuretic-peptide-as-predictor-for-postoperative-outcomes-in-patients-implanted-with-left-ventricular-assist-devices
#9
Gardner Yost, Geetha Bhat, Patroklos Pappas, Antone Tatooles
Brain natriuretic peptide (BNP) is a cardiac neurohormone known to correlate with left ventricular (LV) dilation, decreased contractility, and increased stiffness. Consequently, BNP has been used as a prognostic tool to assess the degree of LV unloading for patients supported by continuous-flow LV assist devices (LVADs). We assessed the prognostic value of changes in BNP in the 2 weeks after LVAD implantation. This retrospective study analyzed laboratory findings and outcomes of 189 LVAD patients. Patients were separated into two groups based on whether serum BNP levels had improved from preoperative levels by postoperative day 14...
April 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29676839/analgesic-consumption-trajectories-in-8-975-patients-1-year-after-fast-track-total-hip-or-knee-arthroplasty
#10
C C Jørgensen, M Petersen, H Kehlet, E K Aasvang
BACKGROUND: Persistent or increased long-term opioid consumption has previously been described following total hip- (THA) and knee arthroplasty (TKA). However, detailed information on postoperative analgesic consumption trajectories and risk factors associated with continued need of analgesics in fast-track THA and TKA is sparse. METHODS: Descriptive multicenter study in primary unilateral fast-track THA or TKA with prospective data on patient characteristics and information on reimbursement entitled dispensed prescriptions of paracetamol, non-steroidal anti-inflammatory drugs, opioids, anticonvulsants, and antidepressants one month preoperatively and one year postoperatively...
April 20, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29675571/prognostic-value-of-n-terminal-pro-b-type-natriuretic-peptide-in-takotsubo-syndrome
#11
Thomas Stiermaier, Francesco Santoro, Tobias Graf, Francesca Guastafierro, Nicola Tarantino, Luisa De Gennaro, Pasquale Caldarola, Matteo Di Biase, Holger Thiele, Natale D Brunetti, Christian Möller, Ingo Eitel
BACKGROUND: Takotsubo syndrome (TTS), a form of acute transient heart failure, has been associated with severe complications and considerable mortality rates. N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) might serve as a marker to identify high-risk patients but has not yet been investigated regarding prognostic implications in TTS. Aim of this study was to determine the short- and long-term prognostic utility of NT-proBNP in patients with TTS. METHODS: The predictive value of admission NT-proBNP was assessed in an international, multicenter study including 177 consecutive TTS patients...
April 19, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29675404/neonatal-hemodynamics-from-developmental-physiology-to-comprehensive-monitoring
#12
REVIEW
Sabine L Vrancken, Arno F van Heijst, Willem P de Boode
Maintenance of neonatal circulatory homeostasis is a real challenge, due to the complex physiology during postnatal transition and the inherent immaturity of the cardiovascular system and other relevant organs. It is known that abnormal cardiovascular function during the neonatal period is associated with increased risk of severe morbidity and mortality. Understanding the functional and structural characteristics of the neonatal circulation is, therefore, essential, as therapeutic hemodynamic interventions should be based on the assumed underlying (patho)physiology...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29674732/evaluation-of-cardiac-risk-in-dental-patients
#13
N J Ransford, L K Stenhouse, J Townend, P Jordan, H Singh
Patients with cardiac disease, cardiac symptoms and related co-morbidities are increasingly being encountered in dental practice. Current methods of medical risk assessment can however be problematic. This paper represents a multi-speciality consensus on how to identify patients that may be more at risk of an adverse cardiac event occurring perio-operatively i.e. during or in the first few weeks after a dental procedure. Drawing on guidelines for surgery and the available literature, we present on an algorithm which aims to inform dental practitioners' decisions about which patients can be managed in primary care and which should be considered for assessment by a dental specialist together with a methodology thereof...
April 20, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29673853/biventricular-dyssynchrony-on-cardiac-magnetic-resonance-imaging-and-its-correlation-with-myocardial-deformation-ventricular-function-and-objective-exercise-capacity-in-patients-with-repaired-tetralogy-of-fallot
#14
Pantelis Kalaitzidis, Stefan Orwat, Aleksander Kempny, Radke Robert, Brigitte Peters, Samir Sarikouch, Philipp Beerbaum, Helmut Baumgartner, Gerhard-Paul Diller
BACKGROUND: Electrical dyssynchrony and prolonged QRS duration are common in patients with repaired tetralogy of Fallot (ToF). It has been linked to increased risk of sudden cardiac death and right ventricular (RV) dysfunction. We investigated myocardial dyssynchrony using cardiac magnetic resonance imaging (CMR) and feature tracking analysis (FT) in this setting and compared it to myocardial deformation, conventional parameters of ventricular dysfunction and clinical parameters. METHODS AND RESULTS: Patients underwent standardized CMR investigations as part of a nationwide study...
April 12, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29673513/long-term-outcomes-after-percutaneous-closure-of-ostium-secundum-atrial-septal-defect-in-the-young-a-nationwide-cohort-study
#15
Zakaria Jalal, Sébastien Hascoët, Céline Gronier, François Godart, Lucia Mauri, Claire Dauphin, Bruno Lefort, Matthias Lachaud, Dominique Piot, Marie-Lou Dinet, Yael Levy, Alain Fraisse, Caroline Ovaert, Xavier Pillois, Jean-René Lusson, Jérôme Petit, Alban-Elouen Baruteau, Jean-Benoit Thambo
OBJECTIVES: This study sought to assess procedural characteristics, early clinical outcome, and long-term complications after transcatheter closure of atrial septal defect (ASD) in children. BACKGROUND: Transcatheter closure has become the preferred strategy in most cases of isolated secundum ASD. However, reported experience in the pediatric population is limited. METHODS: A 1998 to 2016 retrospective multicenter study was performed in 9 French tertiary institutions...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29673293/systemic-thrombolytic-therapy-for-massive-and-submassive-pulmonary-embolism
#16
Lauren A Igneri, John M Hammer
OBJECTIVE: To critically evaluate the published literature assessing the safety and efficacy of thrombolytic therapy for massive and submassive pulmonary embolism (PE). METHODS: A search of human trials in the English-language (September 2017) was conducted through the MEDLINE database using the following terms: PE, tissue plasminogen activator, tenecteplase, and alteplase. 67 unique articles were identified, of which 24 clinical trials discussing clinical outcomes related to administration of either intravenous tenecteplase or alteplase were included...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29672690/infections-and-associated-costs-following-cardiovascular-implantable-electronic-device-implantations-a-nationwide-cohort-study
#17
Nicolas Clémenty, Phuong Lien Carion, Lucie de Léotoing, Ludovic Lamarsalle, Fanny Wilquin-Bequet, Benedict Brown, Koen J P Verhees, Jérôme Fernandes, Jean-Claude Deharo
Aims: This study assessed the contemporary occurrence of cardiac device infections (CDIs) following implantation in French hospitals and estimated associated costs. Methods and Results: A retrospective analysis was conducted on the French National Hospital Database (PMSI). Patients with a record of de novo cardiac implantable electronic device (CIED) implantation or replacement interventions in France in 2012 were identified and followed until the end of 2015. Cardiac device infections (CDIs) were identified based on coding using the French classification for procedures [Classification Commune des Actes Médicaux (CCAM)] and International Classification of Diseases (ICD-10)...
April 17, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29672672/mri-and-neuropsychological-correlates-in-african-americans-with-hypertension-and-left-ventricular-hypertrophy
#18
B Waldron-Perrine, J E Kisser, A Brody, E M Haacke, R Dawood, S Millis, P Levy
Background: African Americans (AA) are at high risk for hypertension (HTN) and poor blood pressure (BP) control. Persistently elevated BP contributes to cardiovascular morbidity. White matter hyperintensities (WMH) are a definable magnetic resonance imaging (MRI) marker of cerebrovascular injury linked to impairments in higher level thinking (i.e., executive functions), memory formation and speed of perceptual-motor processing. Methods: This sub-investigation evaluated neuropsychological functioning in association with WMH on brain MRIs in 23 otherwise healthy hypertensive AAs participating in an NIH-funded study of the effects of Vitamin D on BP and cardiac remodeling in AA patients 30-74 years of age with HTN and left ventricular hypertrophy...
April 17, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29672210/prognostic-utility-of-stress-testing-and-cardiac-biomarkers-in-menopausal-women-at-low-to-intermediate-risk-for-coronary-artery-disease-smart-study-5-year-outcome
#19
Sahar S Abdelmoneim, Caroline A Ball, Francesca Mantovani, Mary E Hagen, Susan Eifert-Rain, Susan Wilansky, Ramon Castello, Patricia A Pellikka, Patricia J M Best, Sharon L Mulvagh
BACKGROUND: In women with low to intermediate risk of coronary artery disease (CAD), prognostic detection strategies have been controversial. We present the follow-up data of the SMART trial in peri/postmenopausal women at low to intermediate risk of CAD. OBJECTIVES: To determine the value of contrast stress echocardiography (CSE), stress electrocardiogram (sECG), and serum biomarkers for prediction of cardiovascular events (CE) in peri/postmenopausal women at low to intermediate risk of CAD...
April 19, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29672182/oral-anticoagulant-use-in-cardiovascular-disorders-a-perspective-on-present-and-potential-indications-for-rivaroxaban
#20
A John Camm, Keith A A Fox
BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) have been approved for use in various cardiovascular indications. The direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors apixaban, edoxaban, and rivaroxaban are now increasingly used in clinical practice. For some of these agents, available data from real-world studies support the efficacy and safety data in phase III clinical trials. OBJECTIVES: This review aims to summarize the current status of trials and observational studies of oral anticoagulant use over the spectrum of cardiovascular disorders (excluding venous thrombosis), provide a reference source beyond stroke prevention for atrial fibrillation (AF) and examine the potential for novel applications in the cardiovascular field...
April 19, 2018: Current Medical Research and Opinion
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