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Heart failure treatment

Shalender Bhasin, Juan P Brito, Glenn R Cunningham, Frances J Hayes, Howard N Hodis, Alvin M Matsumoto, Peter J Snyder, Ronald S Swerdloff, Frederick C Wu, Maria A Yialamas
Objective: To update the "Testosterone Therapy in Men With Androgen Deficiency Syndromes" guideline published in 2010. Participants: The participants include an Endocrine Society-appointed task force of 10 medical content experts and a clinical practice guideline methodologist. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence...
March 17, 2018: Journal of Clinical Endocrinology and Metabolism
Christiana Leimena, Hongyu Qiu
Hypertension is a complex, multifactorial disease that involves the coexistence of multiple risk factors, environmental factors and physiological systems. The complexities extend to the treatment and management of hypertension, which are still the pursuit of many researchers. In the last two decades, various genes have emerged as possible biomarkers and have become the target for investigations of specialized drug design based on its risk factors and the primary cause. Owing to the growing technology of microarrays and next-generation sequencing, the non-protein-coding RNAs (ncRNAs) have increasingly gained attention, and their status of redundancy has flipped to importance in normal cellular processes, as well as in disease progression...
March 21, 2018: International Journal of Molecular Sciences
Kimberly N Means, Amanda E Gentry, Tammy T Nguyen
Introduction: Atrial fibrillation (AF) is a common diagnosis of patients presenting to the emergency department (ED). Intravenous (IV) diltiazem bolus is often the initial drug of choice for acute management of AF with rapid ventricular response (RVR). The route of diltiazem after the initial IV loading dose may influence the disposition of the patient from the ED. However, no studies exist comparing oral (PO) immediate release and IV continuous infusion diltiazem in the emergency setting...
March 2018: Western Journal of Emergency Medicine
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
Francesca Susini, Emilio Assanelli, Elisabetta Doria, Marco Morpurgo, Denise Brusoni, Alice Bonomi, Simone Barbieri, Angelo Cabiati, Laura Salvini, Roberta Chiodelli, Monica Loguercio, Alessandro Galli, Piergiuseppe Agostoni
BACKGROUND: According to guidelines, single determination of B-type Natriuretic peptide (BNP) should be used for distinguishing between cardiac and non-cardiac acute dyspnea at the emergency room. BNP measurement is also recommended before hospital discharge in patients hospitalized for heart failure to assess prognosis and to evaluate treatment efficacy. In acute cardiogenic pulmonary edema, BNP is measured using a single BNP determination, but the temporal behavior of BNP during pulmonary edema recovery is unknown...
March 17, 2018: European Journal of Internal Medicine
Hongju Kim, Jung-Hee Lee
BACKGROUND: Severe aortic stenosis (AS) may lead to acute decompensated heart failure resistant to medical treatment. Here, we report a successful emergent transcatheter aortic valve replacement (TAVR) in a patient presenting with decompensated severe AS accompanied by cardiorenal syndrome. CASE PRESENTATION: A 82-year-old man presented at our emergency department with aggravated dyspnea. His chest X-ray showed bilateral pulmonary edema, and laboratory examination revealed acute kidney injury...
March 20, 2018: BMC Cardiovascular Disorders
Jonathan E Hullmann, Paul J Mather
BACKGROUND: Despite ventricular assist devices (VADs) becoming more common in heart failure (HF) treatment, it is still uncertain which patients are more prone to complications. One potential risk factor is increased body mass index (BMI), which is known to increase both all-cause mortality and mortality from ischemic heart disease; however, the role of the BMI in predicting morbidity and mortality following device implantation is unclear. METHODS: The study population for this single-institution retrospective chart review consisted of 136 patients with HF, who underwent VAD implantation between 2004 and 2015...
January 1, 2018: Progress in Transplantation
Brittney Ann Klein, Béla Reiz, Ian Michael Robertson, Malcolm Irving, Liang Li, Yin-Biao Sun, Brian D Sykes
The development of calcium sensitizers for the treatment of systolic heart failure presents difficulties including judging the optimal efficacy and the specificity to target cardiac muscle. The thin filament is an attractive target since cardiac troponin-C (cTnC) is the site of calcium binding and the trigger for subsequent contraction. One widely studied calcium sensitizer is levosimendan. We have recently shown that when a covalent cTnC-levosimendan analog is exchanged into cardiac muscle cells, they become constitutively active, demonstrating the potency of a covalent complex...
March 20, 2018: Biochemistry
Marcin Kubik, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Ludmiła Daniłowicz-Szymanowicz, Grzegorz Raczak
Left ventricular noncompaction (LVNC) is a unique inherited cardiomyopathy, characterized by an increased risk of adverse cardiovascular events such as heart failure, arrhythmia or sudden cardiac death. Although in comparison to dilated cardiomyopathy, the number of clinical studies concerning LVNC is still small, it is quickly increasing, which reflects a huge effort of the cardiovascular society to develop data to improve understanding of this cardiomyopathy. However, the predictors of adverse outcomes in LVNC are not well established...
March 16, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Pablo Roa Rojas, Hernán Arango Fernández, Martha Rebolledo Cobos, Jonathan Harris Ricardo
Beckwith-Wiedemann syndrome is a rare congenital condition, characterized by presenting macroglossia, defects of the abdominal wall, hemihypertrophy, omphalocele, neonatal hypoglycemia, umbilical hernia, hepatomegaly, cardiac abnormalities, among others. Macroglossia occurs in 90% of cases, causing a problem in chewing, swallowing, phonation and breathing, resulting in a closure of the upper airway. The therapeutic option of choice is partial glossectomy. We present a 2-month-old pediatric patient with Beckwith-Wiedemann syndrome and area blockage due to severe macroglossia; in the medical history, congenital heart disease, interatrial communication, persistent ductus arteriosus, symptomatic epilepsy, renal failure, hypoglycemia, tracheotomy and gastrostomy, due to airway collapse and dysphagia...
April 1, 2018: Archivos Argentinos de Pediatría
M Angeles Tejero Hernández, Elena García Martínez, M José Arroyo Marin, Elena Gómez Guzmán
The cardiorenal syndrome has been defined as a situation in which therapy to relieve congestive symptoms of heart failure is limited by a decreased renal function. The resistance to conventional diuretic treatment makes difficult managing these patients. Tolvaptan, a selective vasopressin-2 receptor antagonist, has been used successfully in adults with this pathology but the experience with children is very limited. A five-year-old girl with renal failure waiting for a heart transplant is presented. Tolvaptan (0...
April 1, 2018: Archivos Argentinos de Pediatría
C Herrmann-Lingen
BACKGROUND: Depression is a frequent comorbidity in chronic heart failure. It can be triggered by the experience of suffering from heart disease, but it can also play a causal role in accelerated development and poor prognosis of heart failure. OBJECTIVES: The aim of this study was to investigate the interrelationships between heart failure and depression and the psychophysiological and behavioral mechanisms involved in this association. The effects of comorbid depression on quality of life in patients with heart failure were also examined and therapeutic options reviewed...
March 20, 2018: Der Internist
Jing Du, Ying Wang, Yan-Chun Li, Tong-Tong Wang, Yong-Lie Zhou, Zhen-Hua Ying
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding...
January 1, 2018: Journal of International Medical Research
Chayakrit Krittanawong, Marrick L Kukin
Heart failure with preserved ejection fraction (HFpEF), a complex and debilitating syndrome, is commonly seen in elderly populations. Exacerbation of HFpEF is among the most common reasons for hospital admission in the USA. The high rate of morbidity and mortality from this condition underscores the fact that HFpEF is heterogeneous, complex, and poorly characterized. Randomized, controlled trials have been very successful at identifying treatments for HF with reduced ejection fraction (HFrEF), but effective treatment options for HFpEF are lacking...
March 20, 2018: Current Treatment Options in Cardiovascular Medicine
Stephen Boone, Dick Kuo
PURPOSE OF REVIEW: Early lowering of blood pressure is advised for patients with severe hypertension associated with signs of impending or progressive organ damage, whereas aggressive treatment is not recommended in patients with asymptomatic severe hypertension. As treatment goals for asymptomatic hypertension and true hypertensive emergency drastically differ, it is essential to identify patients with evidence of impending or progressive organ damage. Biomarkers may assist providers in identifying high-risk patients who would benefit from early blood pressure reduction...
March 19, 2018: Current Hypertension Reports
Tomotaka Ando, Yoshitaka Okuhara, Yoshiyuki Orihara, Koichi Nishimura, Kyoko Yamamoto, Tohru Masuyama, Shinichi Hirotani
Recently, we and other group have reported that furosemide administration along with hypertonic saline solution enhanced diuretic efficiency of furosemide. However, little is known about factors which associated with high diuretic efficiency by hypertonic saline solution with furosemide therapy. To identify predictors of diuretic efficiency in the hypertonic saline solution with furosemide therapy, we recruited 30 consecutive hospitalized heart failure (HF) patients with volume overload (77 ± 10 years, systolic blood pressure > 90 mmHg, and estimated glomerular filtration rate > 15 ml/min/1...
March 19, 2018: Heart and Vessels
Samuel G Wittekind, Yvette Gerdes, Wayne Mays, Clifford Chin, John L Jefferies
Nonischemic dilated cardiomyopathy is deadly and costly, and treatment options are limited. Cardiac rehabilitation has proved safe and beneficial for adults with various types of heart failure. Therefore, we retrospectively evaluated the hypothesis that rehabilitation is safe and improves cardiometabolic health in young patients with nonischemic dilated cardiomypathy. From 2011 through 2015, 8 patients (4 males) (mean age, 20.6 ± 6.6 yr; range, 10-31 yr) underwent rehabilitation at our institution. They were in American Heart Association class C or D heart failure and were on maximal medical therapy...
February 2018: Texas Heart Institute Journal
Khadijah Breathett, Scott Maffett, Randi E Foraker, Rod Sturdivant, Kristina Moon, Ayesha Hasan, Veronica Franco, Sakima Smith, Brent C Lampert, Sitaramesh Emani, Garrie Haas, Rami Kahwash, Ray E Hershberger, Philip F Binkley, Laura Helmkamp, Kathryn Colborn, Pamela N Peterson, Nancy Sweitzer, William T Abraham
BACKGROUND: Heart failure education programs are not standardized. The best form of education is unclear. We evaluated whether addition of a novel tablet application to nurse practitioner (NP) education was superior to NP education alone in reducing 30-day readmission after heart failure hospitalization. METHODS: From 2/2015-3/2016, patients admitted to a quaternary academic center with primary diagnosis of heart failure were randomized to (1) treatment- NP education plus tablet application (interactive conditional logic program that flags patient questions to medical staff) or (2) control- NP education...
March 9, 2018: American Journal of Medicine
Jing Tian, Jiangping Xue, Xiaojuan Hu, Qinghua Han, Yanbo Zhang
BACKGROUND: Due to a lack of an appropriate disease-specific patient-reported outcome (PRO) instrument for chronic heart failure including its social support and treatment aspects in China, this study was performed to develop a patient-reported outcome measure (PROM) for patients with chronic heart failure and evaluate its reliability, validity, and feasibility. METHODS: According to the standard PROM guidelines established by the Food and Drug Administration, an item pool was formed by reviewing a large amount of relevant literature and interviewing patients with chronic heart failure about their main symptoms...
March 20, 2018: Health and Quality of Life Outcomes
Pavel Hála, Mikuláš Mlček, Petr Ošťádal, David Janák, Michaela Popková, Tomáš Bouček, Stanislav Lacko, Jaroslav Kudlička, Petr Neužil, Otomar Kittnar
A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment methods. Here, we present such a model by tachycardia-induced cardiomyopathy, which can be produced by rapid cardiac pacing in swine. A single pacing lead is introduced transvenously into fully anaesthetized healthy swine, to the apex of the right ventricle, and fixated. Its other end is then tunneled dorsally to the paravertebral region. There, it is connected to an in-house modified heart pacemaker unit that is then implanted in a subcutaneous pocket...
February 17, 2018: Journal of Visualized Experiments: JoVE
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