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End stage of heart failure

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https://www.readbyqxmd.com/read/27927755/characteristics-and-outcomes-of-patients-with-myocarditis-listed-for-heart-transplantation
#1
Chantal A ElAmm, Sadeer G Al-Kindi, Guilherme H Oliveira
BACKGROUND: Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients. METHODS AND RESULTS: We queried the UNOS database (United Network for Organ Sharing) for all adults listed for orthotopic heart transplantation (2000-2015) with a listed diagnosis of myocarditis...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27927712/nucleoside-diphosphate-kinase-c-suppresses-camp-formation-in-human-heart-failure
#2
Issam H Abu-Taha, Jordi Heijman, Hans-Jörg Hippe, Nadine M Wolf, Ali El-Armouche, Viacheslav O Nikolaev, Marina Schäfer, Christina Würtz, Stefan Neef, Niels Voigt, István Baczkó, András Varró, Marion Müller, Benjamin Meder, Hugo A Katus, Katharina Spiger, Christiane Vettel, Lorenz H Lehmann, Johannes Backs, Edward Y Skolnik, Susanne Lutz, Dobromir Dobrev, Thomas Wieland
BACKGROUND: -Chronic heart failure (HF) is associated with altered signal transduction via β-adrenoceptors and G proteins, and with reduced cAMP formation. Nucleoside diphosphate kinases (NDPKs) are enriched at the plasma membrane of end-stage HF patients, but the functional consequences of this are largely unknown, particularly for NDPK-C. Here, we investigated the potential role of NDPK-C in cardiac cAMP formation and contractility. METHODS: -Real-time PCR, (Far) Western blot, immunoprecipitation, and immunocytochemistry were used to study the expression, interaction with G proteins, and localization of NDPKs...
December 7, 2016: Circulation
https://www.readbyqxmd.com/read/27927187/the-importance-of-proteinuria-and-prior-cardiovascular-disease-in-all-major-clinical-outcomes-of-atherosclerotic-renovascular-disease-a-single-center-observational-study
#3
Diana Vassallo, James Ritchie, Darren Green, Constantina Chrysochou, Joseph Blunt, Philip A Kalra
BACKGROUND: Identification of patients at risk of developing adverse events would enable aggressive medical therapy and possibly targeted revascularization. The aim of this study is to characterize the determinants of long-term outcomes in atherosclerotic renovascular disease (ARVD). METHODS: Patients with a radiological diagnosis of ARVD were recruited into this single-center prospective cohort study between 1986 and 2014. Data collected included baseline co-morbid conditions, annualized prescribed medications and laboratory data (serum creatinine [υmol/L], proteinuria [g/24 h])...
December 7, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#4
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27909438/donor-specific-regulatory-t-cells-acquired-from-tolerant-mice-bearing-cardiac-allograft-promote-mixed-chimerism-and-prolong-intestinal-allograft-survival
#5
Xiao-Fei Shen, Jin-Peng Jiang, Jian-Jun Yang, Wei-Zhong Wang, Wen-Xian Guan, Jun-Feng Du
The induction of donor-specific transplant tolerance has always been a central problem for small bowel transplantation (SBT), which is thought to be the best therapy for end-stage bowel failure. With the development of new tolerance-inducing strategies, mixed chimerism induced by co-stimulation blockade has become most potent for tolerance of allografts, such as skin, kidney, and heart. However, a lack of clinically available co-stimulation blockers has hindered efficient application in humans. Furthermore, unlike those for other types of solid organ transplantation, strategies to induce robust mixed chimerism for intestinal allografts have not been fully developed...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27908943/planning-for-deactivation-of-implantable-cardioverter-defibrillators-at-the-end-of-life-in-patients-with-heart-failure
#6
Destiny R Brady
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#7
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27891294/prevalence-and-clinical-impact-of-cachexia-in-chronic-illness-in-europe-usa-and-japan-facts-and-numbers-update-2016
#8
EDITORIAL
Stephan von Haehling, Markus S Anker, Stefan D Anker
Cachexia is a serious clinical consequence of almost all chronic diseases when reaching advanced stages. Its prevalence ranges from 5-15% in end-stage chronic heart failure to 50-80% in advanced malignant cancer. Cachexia is also frequently occurring in patients with chronic kidney disease, chronic obstructive pulmonary disease (COPD) or neurological diseases, and rheumatoid arthritis. Mortality rates of patients with cachexia range from 15-25% per year in severe COPD through 20-40% per year in patients with chronic heart failure or chronic kidney disease to 20-80% in cancer cachexia...
December 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27890630/arteriovenous-renal-replacement-therapy-in-end-stage-left-sided-heart-failure-patients-has-detrimental-effect-on-patients-with-impaired-right-ventricular-function
#9
Evangelos Repasos, Elisabeth Kaldara, Christos Pantsios, Chris Kapelios, Emmeleia Nana, Spiridon Vernadakis, Christina Melexopoulou, Konstantinos Malliaras, John Boletis, John N Nanas
INTRODUCTION: Chronic intermittent renal replacement therapy(RRT) is an alternate method of decongestion for patients presenting with diuretic-resistant, end-stage heart failure(HF) and cardiorenal syndrome. The optimal method of vascular access has not been confirmed. This study compared the 6-month outcomes of patients with end-stage HF after the creation of arteriovenous communications (AVC) versus other means of RRT. METHODS: We treated 40 patients with chronic, intermittent, ambulatory RRT, of whom 15 (37...
November 23, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27887692/mechanisms-of-effort-intolerance-in-patients-with-heart-failure-and-borderline-ejection-fraction
#10
Yan Topilsky, Zach Rozenbaum, Shafik Khoury, Gregg S Pressman, Yaniv Gura, Jack Sherez, Avi Man, Jason Shimiaie, Sanford Edwards, Joshua Berookhim, Thierry Le Tourneau, Amir Halkin, Simon Biner, Gad Keren, Galit Aviram
Combining echocardiography and cardiopulmonary stress testing allows noninvasive assessment of hemodynamics, and oxygen extraction (A-VO2 difference). We evaluated mechanisms of effort intolerance in patients with heart failure with borderline (40% to 49%) left ventricular ejection fraction (EF) (HF and Borderline Ejection fraction). We included 89 consecutive patients with HF and Borderline Ejection fraction (n = 25; 63.6 ± 14 years, 64% men), control subjects (n = 22), patients with HF with preserved EF (n = 26; EF ≥50%), and patients with HF with reduced EF (n = 16; <40%)...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27884249/long-term-arrhythmic-and-nonarrhythmic-outcomes-of-lamin-a-c-mutation-carriers
#11
Saurabh Kumar, Samuel H Baldinger, Estelle Gandjbakhch, Philippe Maury, Jean-Marc Sellal, Alexander F A Androulakis, Xavier Waintraub, Philippe Charron, Anne Rollin, Pascale Richard, William G Stevenson, Ciorsti J Macintyre, Carolyn Y Ho, Tina Thompson, Jitendra K Vohra, Jonathan M Kalman, Katja Zeppenfeld, Frederic Sacher, Usha B Tedrow, Neal K Lakdawala
BACKGROUND: Mutations in LMNA are variably expressed and may cause cardiomyopathy, atrioventricular block (AVB), or atrial arrhythmias (AAs) and ventricular arrhythmias (VA). Detailed natural history studies of LMNA-associated arrhythmic and nonarrhythmic outcomes are limited, and the prognostic significance of the index cardiac phenotype remains uncertain. OBJECTIVES: This study sought to describe the arrhythmic and nonarrhythmic outcomes of LMNA mutation carriers and to assess the prognostic significance of the index cardiac phenotype...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27875721/percutaneous-mitral-valve-repair-the-last-chance-for-symptoms-improvement-in-advanced-refractory-chronic-heart-failure
#12
Alessandra Berardini, Elena Biagini, Francesco Saia, Davide Stolfo, Mario Previtali, Francesco Grigioni, Bruno Pinamonti, Gabriele Crimi, Alessandro Salvi, Maurizio Ferrario, Antonio De Luca, Fabrizio Gazzoli, Maria Letizia Bacchi Reggiani, Claudia Raineri, Gianfranco Sinagra, Claudio Rapezzi
BACKGROUND: The role of percutaneous mitral valve repair (PMVR) in patients with end-stage heart failure (HF) and functional mitral regurgitation (FMR) is unclear. METHODS: Seventy-five consecutive patients with FMR grade≥3+ and severe HF symptoms despite optimal medical therapy and resynchronization therapy underwent PMVR with the MitraClip system (Abbott, Abbott Park, IL, USA) at 3 centers. Clinical evaluation, echocardiography and pro-BNP measurement were performed at baseline and at 6-month...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27870655/blood-pressure-treatment-levels-and-choice-of-antihypertensive-agent-in-people-with-diabetes-mellitus-an-overview-of-systematic-reviews
#13
Mattias Brunström, Mats Eliasson, Peter M Nilsson, Bo Carlberg
OBJECTIVE: Multiple systematic reviews address the effect of antihypertensive treatment in people with diabetes. Here, we summarize current systematic reviews concerning antihypertensive treatment effect at different blood pressure (BP) levels, and relative treatment effect of different antihypertensive agents. METHODS: We searched MEDLINE, BIOSIS, DARE and CDSR during years 2005-2016. Eligibility criteria, number of trials and participants, outcomes analysed, statistical methods used for data synthesis, and principal results were extracted for each review...
November 18, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27867961/cardio-renal-protection-with-empagliflozin
#14
Richard J MacIsaac, George Jerums, Elif I Ekinci
Cardiovascular (CV) and kidney disease are common and significant complications in people with type 2 diabetes (T2DM). CV disease is the leading cause of death, morbidly and hospitalisations for people with T2DM. Furthermore, diabetic kidney disease is a major risk factor for CV disease and is the main reason why patients need renal replacement therapy. In this perspective, we highlight the results of the recent landmark EMPA-REG OUTCOME trial which has shown that empagliflozin, a member of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor class of glucose lowering medications, reduces death from CV causes, hospitalisation for heart failure and progression to end stage kidney disease in patients with T2DM and established CV disease...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27865440/hemoglobin-of-12-g-dl-and-above-is-not-associated-with-increased-cardiovascular-morbidity-in-children-on-hemodialysis
#15
Michelle N Rheault, Julia T Molony, Thomas Nevins, Charles A Herzog, Blanche M Chavers
In adults on chronic hemodialysis, achieving a hemoglobin concentration of 12g/dl and above with erythropoiesis stimulating agents leads to increased cardiovascular events and mortality, but this may not be true in children. Therefore, we conducted a retrospective cohort study of pediatric patients (under 18) from the Centers for Medicare and Medicaid Services End Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) project (2000 to 2008) merged with the United States Renal Data System. Hemoglobin was determined from the Clinical Performance Measures data, and beginning annually on January 1st of the next year, patients were followed for up to 1 year...
November 16, 2016: Kidney International
https://www.readbyqxmd.com/read/27862767/dynamics-of-cerebral-blood-flow-in-patients-with-mild-non-ischaemic-heart-failure
#16
Christian D Erkelens, Haye H van der Wal, Bauke M de Jong, Jan-Willem Elting, Remco Renken, Marleen Gerritsen, Peter Jan van Laar, Vincent M van Deursen, Peter van der Meer, Dirk J van Veldhuisen, Adriaan A Voors, Gert-Jan Luijckx
AIMS: Heart failure (HF) is associated with tissue hypoperfusion and congestion leading to organ dysfunction. Although cerebral blood flow (CBF) is preserved over a wide range of perfusion pressures in healthy subjects, it is impaired in end-stage HF. We aimed to compare CBF, autoregulation, and cognitive function in patients with mild non-ischaemic HF with healthy controls. METHODS AND RESULTS: Fifteen patients with mild idiopathic dilated cardiomyopathy and 15 matched healthy controls were studied...
November 14, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27862075/minimally-invasive-implantation-of-heartware-assist-device-and-simultaneous-tricuspid-valve-reconstruction-through-partial-upper-sternotomy
#17
Julia Hillebrand, Andreas Hoffmeier, Tonny Djie Tiong Tjan, Juergen R Sindermann, Christoph Schmidt, Sven Martens, Mirela Scherer
Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27861600/heart-rate-dependence-of-the-pulmonary-resistance-x-compliance-rc-time-and-impact-on-right-ventricular-load
#18
Thomas S Metkus, Christopher J Mullin, E Wilson Grandin, J Eduardo Rame, Emmanouil Tampakakis, Steven Hsu, Todd M Kolb, Rachel Damico, Paul M Hassoun, David A Kass, Stephen C Mathai, Ryan J Tedford
BACKGROUND: The effect of heart rate (HR) and body surface area (BSA) on pulmonary RC time and right ventricular (RV) load is unknown. METHODS: To determine the association of HR and BSA with the pulmonary RC time and measures of RV load, we studied three large patient cohorts including subjects with 1) known or suspected pulmonary arterial hypertension (PAH) (n = 1008), 2) pulmonary hypertension due to left heart disease (n = 468), and 3) end-stage heart failure with reduced ejection fraction (n = 150)...
2016: PloS One
https://www.readbyqxmd.com/read/27861429/clinical-implications-of-physiological-flow-adjustment-in-continuous-flow-left-ventricular-assist-devices
#19
Vakhtang Tchantchaleishvili, Jessica G Y Luc, Caitlin M Cohan, Kevin Phan, Laila Hübbert, Steven W Day, H Todd Massey
There is increasing evidence for successful management of end-stage heart failure with continuous-flow left ventricular assist device (CF-LVAD) technology. However, passive flow adjustment at fixed CF-LVAD speed is susceptible to flow balancing issues as well as adverse hemodynamic effects relating to the diminished arterial pulse pressure and flow. With current therapy, flow cannot be adjusted with changes in venous return, which can vary significantly with volume status. This limits the performance and safety of CF-LVAD...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27858326/left-ventricular-assist-devices-impact-hospital-resource-utilization-without-affecting-patient-mortality-in-gastrointestinal-bleeding
#20
Feng Li, Alice Hinton, Alan Chen, Nishaki K Mehta, Samer Eldika, Cheng Zhang, Hisham Hussan, Darwin L Conwell, Somashekar G Krishna
BACKGROUND: Left ventricular assist devices (LVADs) are being utilized for management of end-stage heart failure and require systemic anticoagulation. Gastrointestinal bleeding (GIB) is one of the most common adverse events following LVAD implantation. AIM: To investigate the impact of continuous-flow (CF) LVAD implants on outcomes of patients admitted with GIB. METHODS: This is a cross-sectional study utilizing the Nationwide Inpatient Sample in the CF-LVAD era from 2010 to 2012...
November 17, 2016: Digestive Diseases and Sciences
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