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End stage of heart failure

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https://www.readbyqxmd.com/read/28645834/left-ventricular-assist-device-therapy-for-destination-therapy-is-less-invasive-surgery-a-safe-alternative
#1
Sebastian V Rojas, Jasmin S Hanke, Murat Avsar, Philipp R Ahrens, Ove Deutschmann, Kirstin A Tümler, Aitor Uribarri, Sara Rojas-Hernández, Pedro L Sánchez, José M González-Santos, Axel Haverich, Jan D Schmitto
INTRODUCTION AND OBJECTIVES: The number of older patients with congestive heart failure has dramatically increased. Because of stagnating cardiac transplantation, there is a need for an alternative therapy, which would solve the problem of insufficient donor organ supply. Left ventricular assist devices (LVADs) have recently become more commonly used as destination therapy (DT). Assuming that older patients show a higher risk-profile for LVAD surgery, it is expected that the increasing use of less invasive surgery (LIS) LVAD implantation will improve postoperative outcomes...
June 20, 2017: Revista Española de Cardiología
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/28636749/annual-direct-medical-costs-associated-with-diabetes-related-complications-in-the-event-year-and-in-subsequent-years-in-hong-kong
#3
F Jiao, C K H Wong, S C W Tang, C S C Fung, K C B Tan, S McGhee, R Gangwani, C L K Lam
AIM: To develop models to estimate the direct medical costs associated with diabetes-related complicationsin the event year and in subsequent years. METHODS: The public direct medical costs associated with 13 diabetes-related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross-sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co-existing complications...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28633804/protective-effect-of-n-acetylcysteine-on-progression-to-end-stage-renal-disease-necessity-for-prospective-clinical-trial
#4
Chen-Yi Liao, Chi-Hsiang Chung, Chai-Chao Wu, Fu-Huang Lin, Chang-Huei Tsao, Chih-Chiang Wang, Wu-Chien Chien
BACKGROUND: We aimed to evaluate the potential benefits of N-acetylcysteine (NAC) on the risk of chronic kidney disease (CKD) progression to dialysis-requiring end-stage renal disease (ESRDd). METHODS: In a population-based cohort study of 145,062 individuals, 123,608 CKD patients who were followed up for 10years were included, and CKD patients treated with NAC (ICD-9-CM) were compared with those who were not treated. Using propensity score matching, we analyzed the predictors of CKD progression to ESRDd by Cox proportional hazards regression with adjustments for sex, age, and comorbidities, and evaluated the effect of NAC using cumulative defined daily dose (cDDD)...
June 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28619598/incremental-prognostic-value-of-a-complex-left-ventricular-remodeling-classification-in-asymptomatic-for-heart-failure-hypertensive-patients
#5
Iacopo Fabiani, Nicola Riccardo Pugliese, Salvatore La Carrubba, Lorenzo Conte, Francesco Antonini-Canterin, Paolo Colonna, Frank Benedetto, Enrico Calogero, Valentina Barletta, Scipione Carerj, Simona Buralli, Stefano Taddei, Maria Francesca Romano, Vitantonio Di Bello
We evaluated the prognostic impact of a complex remodeling classification (CRC) in asymptomatic patients with arterial hypertension (AH). We retrospectively included 749 hypertensive patients (female 325, 43.4% age 62 ± 11.3 years) in Stages A and B of heart failure. CRC was evaluated including indexed left ventricular mass, end-diastolic volume, and relative wall thickness. After 45-month follow-up, we considered a composite endpoint: total mortality, myocardial infarction, myocardial revascularization, cerebrovascular events, and acute pulmonary edema...
May 25, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28617969/conditionally-targeted-deletion-of-psen1-leads-to-diastolic-heart-dysfunction
#6
Xiao-Wei Song, Qing-Ning Yuan, Ying Tang, Mi Cao, Ya-Feng Shen, Zhen-Yu Zeng, Chang-Hai Lei, SongHua Li, Xian-Xian Zhao, Yong-Ji Yang
Recently, PSEN1 has been reported to have mutations in dilated cardiomyopathy pedigrees. However, the function and mechanism of PSEN1 in cardiomyopathy remains unresolved. Here, we established 4 types of genetically modified mice to determine the function of PSEN1 in cardiac development and pathology. PSEN1 null mutation resulted in perinatal death, retardation of heart growth, ventricular dilatation, septum defects, and valvular thickening. PSEN1 knockout in adults led to decreased muscle fibers, widened sarcomere Z lines and reduced lengths of sarcomeres in cardiomyocytes...
June 15, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28611860/renal-function-and-outcomes-with-use-of-left-ventricular-assist-device-implantation-and-inotropes-in-end-stage-heart-failure-a-retrospective-single-center-study
#7
Sean Verma, Emmanuel Bassily, Shane Leighton, Rahul Mhaskar, Igor Sunjic, Angel Martin, Nancy Rihana, Tambi Jarmi, Claude Bassil
BACKGROUND: Left ventricular assist device (LVAD) and inotrope therapy serve as a bridge to transplant (BTT) or as destination therapy in patients who are not heart transplant candidates. End-stage heart failure patients often have impaired renal function, and renal outcomes after LVAD therapy versus inotrope therapy have not been evaluated. METHODS: In this study, 169 patients with continuous flow LVAD therapy and 20 patients with continuous intravenous inotrope therapy were analyzed...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28611127/pulmonary-hypertension-is-associated-with-a-higher-risk-of-heart-failure-hospitalization-and-mortality-in-patients-with-chronic-kidney-disease-the-jackson-heart-study
#8
Senthil Selvaraj, Sanjiv J Shah, Mark J Ommerborn, Cheryl R Clark, Michael E Hall, Robert J Mentz, Saadia Qazi, Jeremy M Robbins, Thomas N Skelton, Jiaying Chen, J Michael Gaziano, Luc Djoussé
BACKGROUND: African Americans develop chronic kidney disease and pulmonary hypertension (PH) at disproportionately high rates. Little is known whether PH heightens the risk of heart failure (HF) admission or mortality among chronic kidney disease patients, including patients with non-end-stage renal disease. METHODS AND RESULTS: We analyzed African Americans participants with chronic kidney disease (estimated glomerular filtration rate <60 mL/min per 1.73 m(2) or urine albumin/creatinine >30 mg/g) and available echocardiogram-derived pulmonary artery systolic pressure (PASP) from the Jackson Heart Study (N=408)...
June 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28602846/granulocyte-colony-stimulating-factor-for-the-treatment-of-cardiovascular-diseases-an-update-with-a-critical-appraisal
#9
REVIEW
Domenico D'Amario, Antonio Maria Leone, Josip Anđelo Borovac, Francesco Cannata, Andrea Siracusano, Giampaolo Niccoli, Filippo Crea
Heart failure and acute myocardial infarction are conditions that are associated with high morbidity and mortality. Significant dysfunction of the heart muscle can occur as the consequence of end-stage chronic cardiovascular diseases or acute ischemic events that are marked by large infarction area and significant tissue necrosis. Despite the remarkable improvement of conventional treatments, a substantial proportion of patients still develops severe heart failure that can only be resolved by heart transplantation or mechanical device implantation...
June 7, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28602210/renal-allograft-outcome-after-simultaneous-heart-and-kidney-transplantation
#10
Avishay Grupper, Ayelet Grupper, Richard C Daly, Naveen L Pereira, Matthew A Hathcock, Walter K Kremers, Fernando G Cosio, Brooks S Edwards, Sudhir S Kushwaha
Chronic kidney disease frequently accompanies end-stage heart failure and may result in consideration of simultaneous heart and kidney transplantation (SHKT). In recent years, there has been a significant increase in SHKT. This single-center cohort consisted of 35 patients who underwent SHKT during 1996 to 2015. The aim of this study was to review factors that may predict better long-term outcome after SKHT. Thirteen patients (37%) had delayed graft function (DGF) after transplant (defined as the need for dialysis during the first 7 days after transplant), which was significantly associated with mechanical circulatory support device therapy and high right ventricular systolic pressure before transplant...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28599901/esrd-after-heart-failure-myocardial-infarction-or-stroke-in-type%C3%A2-2-diabetic-patients-with-ckd
#11
David M Charytan, Scott D Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E Cooper, Janet B McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K Singh, Emmanuel A Burdmann, Andrew S Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J V McMurray, Brian Claggett, Eldrin F Lewis, Marc A Pfeffer
BACKGROUND: How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). PREDICTOR: Postrandomization CV events. OUTCOMES: ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event...
June 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28580208/heart-transplantation-in-patients-with-dystrophinopathic-cardiomyopathy-review-of-the-literature-and-personal-series
#12
REVIEW
Andrea Antonio Papa, Paola D'Ambrosio, Roberta Petillo, Alberto Palladino, Luisa Politano
Cardiomyopathy associated with dystrophinopathies [Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), X-linked dilated cardiomyopathy (XL-dCM) and cardiomyopathy of Duchenne/Becker (DMD/BMD) carriers] is an increasing recognized manifestation of these neuromuscular disorders and notably contributes to their morbidity and mortality. Dystrophinopathic cardiomyopathy (DCM) is the result of the dystrophin protein deficiency at the myocardium level, parallel to the deficiency occurring at the skeletal muscle level...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28575239/whole-genome-cardiac-dna-methylation-fingerprint-and-gene-expression-analysis-provide-new-insights-in-the-pathogenesis-of-chronic-chagas-disease-cardiomyopathy
#13
Laurie Laugier, Amanda Farage Frade, Frederico Moraes Ferreira, Monique Andrade Baron, Priscila Camillo Teixeira, Sandrine Cabantous, Ludmila Rodrigues Pinto Ferreira, Laurence Louis, Vagner Oliveira Carvalho Rigaud, Fabio Antônio Gaiotto, Fernando Bacal, Pablo Pomerantzeff, Edimar Bocchi, Jorge Kalil, Ronaldo Honorato Barros Santos, Edecio Cunha-Neto, Christophe Chevillard
Background: Chagas disease, caused by the protozoan Trypanosoma cruzi, is endemic in Latin America and affects 10 million people worldwide. Approximately 12,000 deaths attributable to Chagas disease occur annually due to Chagas disease cardiomyopathy (CCC), an inflammatory cardiomyopathy presenting with heart failure and arrythmia; 30% of infected subjects develop CCC years after infection. Genetic mechanisms play a role in differential progression to CCC, but little is known about the role of epigenetic modifications in pathological gene expression patterns in CCC patients' myocardium...
May 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28571618/repetitive-use-of-levosimendan-in-advanced-heart-failure-need-for-stronger-evidence-in-a-field-in-dire-need-of-a-useful-therapy
#14
Gerhard Pölzl, Johann Altenberger, Loant Baholli, Paola Beltrán, Attila Borbély, Josep Comin-Colet, Juan F Delgado, Francesco Fedele, Antonella Fontana, Friedrich Fruhwald, Gregory Giamouzis, George Giannakoulas, Martín J Garcia-González, Finn Gustafsson, Kari Kaikkonen, Matti Kivikko, Jacek Kubica, Dirk von Lewinski, Ida Löfman, Gabriella Malfatto, Nicolás Manito, Martin Martínez-Sellés, Josep Masip, Bela Merkely, Fabrizio Morandi, Henning Mølgaard, Fabrizio Oliva, Emil Pantev, Zoltán Papp, Gian Piero Perna, Roman Pfister, Vito Piazza, Ramón Bover, Diego Rangel-Sousa, Alejandro Recio-Mayoral, Alexander Reinecke, Andreas Rieth, Toni Sarapohja, Gunter Schmidt, Mirko Seidel, Stefan Störk, Bojan Vrtovec, Gerhard Wikström, Patrik Yerly, Piero Pollesello
Patients in the latest stages of heart failure are severely compromised, with poor quality of life and frequent hospitalizations. Heart transplantation and left ventricular assist device implantation are viable options only for a minority, and intermittent or continuous infusions of positive inotropes may be needed as a bridge therapy or as a symptomatic approach. In these settings, levosimendan has potential advantages over conventional inotropes (catecholamines and phosphodiesterase inhibitors), such as sustained effects after initial infusion, synergy with beta-blockers, and no increase in oxygen consumption...
May 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28569289/what-happens-to-the-heart-in-chronic-kidney-disease
#15
E Rutherford, P B Mark
Cardiovascular disease is common in patients with chronic kidney disease. The increased risk of cardiovascular disease seen in this population is attributable to both traditional and novel vascular risk factors. Risk of sudden cardiac or arrhythmogenic death is greatly exaggerated in chronic kidney disease, particularly in patients with end stage renal disease where the risk is roughly 20 times that of the general population. The reasons for this increased risk are not entirely understood and while atherosclerosis is accelerated in the presence of chronic kidney disease, premature myocardial infarction does not solely account for the excess risk...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28568427/left-ventricular-ejection-fraction-of%C3%A2-%C3%A2-20-too-bad-for-mitraclip%C3%A2
#16
Sebastian Barth, Martina B Hautmann, Sebastian Kerber, Frank Gietzen, Wilko Reents, Michael Zacher, Philipp Halbfass, Daniel P Griese, Bernhard Schieffer, Karsten Hamm
OBJECTIVES: This study sought to investigate whether the percutaneous mitral regurgitation (MR) reduction with the MitraClip® system in end-stage heart failure patients with a left ventricular ejection fraction (LVEF) of <20% also effects beneficial outcome or whether the underlying myogenic problem is leading and therefore of prognostic relevance. BACKROUND: The interventional treatment of functional mitral regurgitation (FMR) with the MitraClip(®) system could improve the clinical and hemodynamic outcome in patients with severely impaired left ventricular function...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28560811/comparing-the-effectiveness-of-dynamic-treatment-strategies-using-electronic-health-records-an-application-of-the-parametric-g-formula-to-anemia-management-strategies
#17
Yi Zhang, Jessica G Young, Mae Thamer, Miguel A Hernán
OBJECTIVE: To compare the effectiveness of dynamic anemia management strategies by applying the parametric g-formula to electronic health records. DATA SOURCE/STUDY SETTING: Patients with end-stage renal disease from the US Renal Data System who had congestive heart failure or ischemic heart disease and were undergoing hemodialysis in outpatient dialysis facilities between 2006 and 2010. STUDY DESIGN: We explicitly emulated a target trial of three ‎erythropoietin dosing strategies (aimed at achieving a low, middle, or high hematocrit) and estimated the observational analog of the per-protocol effect...
May 30, 2017: Health Services Research
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
#18
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/28557861/heartmate-3-in-lowest-intermacs-profile-cohort-the-swiss-experience
#19
Piergiorgio Tozzi, Carlo Banfi, Kameran Ahmadov, Roger Hullin, Philippe Meyer, Raphael Giraud, Lucas Liaudet, Fabrizio Gronchi, Christophe Huber, Matthias Kirsch
New generation devices for long-term mechanical circulatory support are centrifugal pumps having fully magnetically levitated rotors to reduce blood trauma. Recently, the novel HeartMate 3 was cleared for clinical application in Switzerland. In two Swiss University Hospitals part of the "Lausanne-Geneva Transplantation Network," 10 consecutive patients in end-stage heart failure received the HeartMate 3. Device implantation criteria were persistent low output syndrome despite optimal medical treatment. The primary end-point of the study was survival or transplantation to 90 days on the device...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28554716/acute-hemodynamic-effects-of-intra-aortic-balloon-counterpulsation-pumps-in-advanced-heart-failure
#20
Shiva K Annamalai, Lyanne Buiten, Michele L Esposito, Vikram Paruchuri, Andrew Mullin, Catalina Breton, Robert Pedicini, Ryan O'Kelly, Kevin Morine, Benjamin Wessler, Ayan R Patel, Michael S Kiernan, Richard H Karas, Navin K Kapur
BACKGROUND: The utility of intra-aortic balloon counterpulsation pumps (IABPs) in low cardiac output states is unknown and no studies have explored the impact of IABP therapy on ventricular workload in patients with advanced HF. For these reasons, we explored the acute hemodynamic effects of IABP therapy in patients with advanced HF. METHODS: We prospectively studied 10 consecutive patients with Stage D HF referred for IABP placement prior to LVAD surgery and compared to five control patients with preserved left ventricular (LV) ejection fraction (EF) who did not receive IABP therapy...
May 26, 2017: Journal of Cardiac Failure
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