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https://www.readbyqxmd.com/read/28530783/a-rare-case-of-obscure-gastrointestinal-bleeding-small-bowel-varices-flowing-into-the-inferior-epigastric-vein
#1
Akira Hoshiai, Junya Tsurukiri, Yasuhiro Sumi
Ectopic varices include all varices except esophageal or gastric varices and comprise large portosystemic venous collaterals that occur anywhere in the abdomen. Ectopic varices are relatively rare; however, approximately 5% are related to gastrointestinal bleeding. Ectopic varices usually occur in the rectum, duodenum, or colon, and portal hypertension is the most common cause. Hemodynamic profiles of ectopic varices remain unknown, and extensive bleeding from these structures occurs because diagnosis and treatment are difficult...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28527831/different-efficacy-of-inhaled-and-oral-medications-in-pulmonary-hypertension
#2
Batool J AbuHalimeh, Joseph G Parambil, Adriano R Tonelli
Pulmonary arterial hypertension (PAH) is progressive disorder characterized by elevated pulmonary vascular resistance that can lead to right heart failure and death. One of the main therapeutic options for PAH are medications targeting the prostacyclin pathway. Treprostinil is a prostacyclin analogue and selexipag is a selective IP receptor agonist. Treprostinil can be delivered by a variety of routes including oral, inhaled, subcutaneous and intravenous. Selexipag is currently approved as an oral formulation...
May 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28527771/aspirin-versus-aspirin-plus-clopidogrel-as-antithrombotic-treatment-following-transcatheter-aortic-valve-replacement-with-a-balloon-expandable-valve-the-arte-aspirin-versus-aspirin%C3%A2-clopidogrel-following%C3%A2-transcatheter-aortic-valve-implantation-randomized%C3%A2
#3
Josep Rodés-Cabau, Jean-Bernard Masson, Robert C Welsh, Bruno Garcia Del Blanco, Marc Pelletier, John G Webb, Faisal Al-Qoofi, Philippe Généreux, Gabriel Maluenda, Martin Thoenes, Jean-Michel Paradis, Chekrallah Chamandi, Vicenç Serra, Eric Dumont, Mélanie Côté
OBJECTIVE: The aim of this study was to compare aspirin plus clopidogrel with aspirin alone as antithrombotic treatment following transcatheter aortic valve replacement (TAVR) for the prevention of ischemic events, bleeding events, and death. BACKGROUND: Few data exist on the optimal antithrombotic therapy following TAVR. METHODS: This was a randomized controlled trial comparing aspirin (80 to 100 mg/day) plus clopidogrel (75 mg/day) (dual-antiplatelet therapy [DAPT]) versus aspirin alone (single-antiplatelet therapy [SAPT]) in patients undergoing TAVR with a balloon-expandable valve...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28526502/hemodynamic-parameters-predict-adverse-outcomes-following-biventricular-conversion-with-single-ventricle-palliation-takedown
#4
Melissa A Herrin, David Zurakowski, Christopher W Baird, Puja Banka, Jesse J Esch, Pedro J Del Nido, Sitaram M Emani
OBJECTIVE: Patients with a borderline left ventricular hypoplasia in the hypoplastic left heart syndrome variant or an unbalanced atrioventricular canal who undergo initial single-ventricle palliation may be candidates for biventricular (BiV) conversion following left ventricle (LV) recruitment procedures. We investigated associations among preoperative parameters and postoperative outcomes in patients undergoing BiV conversion. METHODS: We performed a retrospective review of patients who underwent BiV conversion to determine variables associated with clinical outcomes...
April 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28522107/differences-in-neurohumoral-and-hemodynamic-response-to-prolonged-head-up-tilt-between-patients-with-high-and-normal-standing-norepinephrine-forms-of-postural-orthostatic-tachycardia-syndrome
#5
Luka Crnošija, Magdalena Krbot Skorić, Mila Lovrić, Anamari Junaković, Vladimir Miletić, Rujana Šprljan Alfirev, Antun Pavelić, Ivan Adamec, Mario Habek
OBJECTIVE: To investigate the optimal timing for blood sample collection of catecholamines and the possible correlations between neurohumoral and hemodynamic responses to prolonged head-up tilt (HUT) in postural orthostatic tachycardia syndrome (POTS). METHODS: Nineteen patients underwent a 30-minute, 70° HUT test. Blood samples (norepinephrine (NE), epinephrine and dopamine) were taken in the 10th minute of supine, and 10th, 20th and 30th minutes of HUT. RESULTS: There were no significant differences in the proportion of high and normal standing NE patients in the different time points...
May 11, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28521931/hemodynamic-measurements-for%C3%A2-the%C3%A2-selection-of-patients-with-renal%C3%A2-artery%C3%A2-stenosis-a-systematic-review
#6
REVIEW
Peter M van Brussel, Tim P van de Hoef, Robbert J de Winter, Liffert Vogt, Bert-Jan van den Born
Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28521863/high-pre-ischemic-fatty-acid-levels-decrease-cardiac-recovery-in-an-isolated-rat-heart-model-of-donation-after-circulatory-death
#7
Petra Niederberger, Emilie Farine, Maria Arnold, Rahel K Wyss, Maria N Sanz, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
RATIONALE: Donation after circulatory death (DCD) could improve cardiac graft availability. However, strategies to optimize cardiac graft recovery remain to be established in DCD; these hearts would be expected to be exposed to high levels of circulatory fat immediately prior to the inevitable period of ischemia prior to procurement. OBJECTIVE: We investigated whether acute exposure to high fat prior to warm, global ischemia affects subsequent hemodynamic and metabolic recovery in an isolated rat heart model of DCD...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28515936/pulse-dose-steroids-in-severe-pulmonary-arterial-hypertension-secondary-to-systemic-lupus-erythematosus
#8
Cody Lee, Jean Elwing
OBJECTIVE: The pulmonary vascular targeted treatment for systemic lupus erythematosus-associated pulmonary arterial hypertension is similar to other connective tissue disease-associated pulmonary arterial hypertension. In addition, there also appears to be a role for immunosuppression in the overall management. However, the optimal immunosuppressive regimen and what patients will respond to treatments are currently not clearly elucidated given the lack of randomized controlled trials on the subject...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28513192/the-haemodynamic-effect-of-an-adjustable-band-in-an-arteriovenous-fistula
#9
M Sturm, H Lee, S Thomas, T Barber
A number of treatment approaches exist for excessive flowrate arteriovenous fistulae. Banding has a number of advantages, yet there is concern over its use due to reported high post-surgery thrombosis rates. A computational study is conducted of a new technique, to elucidate the hemodynamics present in the process. The key improvement involves the use of an adjustable band which can be used to optimise the flowrate during the surgery. The pressure and flowrate changes are apparent from the computational results and the computational results also demonstrate that further optimization may be possible...
May 17, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28507835/endoscopic-view-of-gastroduodenal-artery-coils-at-the-base-of-duodenal-ulcer-in-case-of-recurrent-massive-upper-gastrointestinal-bleed
#10
Rawaa Ebrahem, Salam Kadhem, John W Frey, William Salyers
Helicobacter pylori (H. pylori) infection is one of the major causes of bleeding peptic ulcer disease, which is associated with serious complications; therefore, the eradication of H. pylori is essential to prevent these devastating complications. Post-treatment follow-up is crucial to guarantee the eradication of the organism and may be conducted via the urea breath test, the stool antigen test, or a gastric biopsy. Acute massive upper gastrointestinal (UGI) bleeding is one of the most common complications of peptic ulcer disease...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28507172/hemodynamic-and-mechanical-properties-of-the-proximal-aorta-in-young-and-middle-aged-adults-with-isolated-systolic-hypertension-the-dallas-heart-study
#11
Yuichiro Yano, Ian J Neeland, Colby Ayers, Ronald Peshock, Jarett D Berry, Donald M Lloyd-Jones, Philip Greenland, Gary F Mitchell, Wanpen Vongpatanasin
The aim of this study was to assess characteristic impedance (Zc) of the proximal aorta in young and middle-aged individuals with isolated systolic hypertension (ISH). Zc is an index of aortic stiffness relative to aortic size. In the Dallas Heart Study, 2001 untreated participants 18 to 64 years of age (mean age: 42.3 years; 44% black race) were divided into the following groups based on office blood pressure (BP) measurements: (1) optimal BP (systolic BP [SBP] <120 mm Hg and diastolic BP [DBP] <80 mm Hg; n=837); (2) prehypertension (SBP 120-139 mm Hg and DBP 80-89 mm Hg; n=821); (3) ISH (SBP ≥140 mm Hg and DBP <90 mm Hg; n=121); (4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg; n=44); and (5) systolic-diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg; n=178)...
May 15, 2017: Hypertension
https://www.readbyqxmd.com/read/28502795/multi-scale-tailor-made-heart-simulation-can-predict-the-effect-of-cardiac-resynchronization-therapy
#12
Jun-Ichi Okada, Takumi Washio, Machiko Nakagawa, Masahiro Watanabe, Yoshimasa Kadooka, Taro Kariya, Hiroshi Yamashita, Yoko Yamada, Shin-Ichi Momomura, Ryozo Nagai, Toshiaki Hisada, Seiryo Sugiura
BACKGROUND: The currently proposed criteria for identifying patients who would benefit from cardiac resynchronization therapy (CRT) still need to be optimized. A multi-scale heart simulation capable of reproducing the electrophysiology and mechanics of a beating heart may help resolve this problem. The objective of this retrospective study was to test the capability of patient-specific simulation models to reproduce the response to CRT by applying the latest multi-scale heart simulation technology...
May 11, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28501076/intravenous-contrast-friend-or-foe-a-review-on-contrast-induced-nephropathy
#13
REVIEW
Catherine Do
Intravenous iodinated contrast is used in many contrasted imaging studies ranging from computed tomography to angiography. The risks of contrast-induced nephropathy (CIN) and its incidence have not been clearly defined. Most iodinated contrast media used today are hypertonic compared with serum osmolality and pose biological risks. However, the risk of CIN in the general population may be overestimated. Confounding risk factors may contribute to acute kidney injury other than attributable risk of contrast exposure...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28500176/mitral-aortic-flow-reversal-in-cardiac-resynchronization-therapy-coupling-with-ejection-and-impact-of-variations-in-atrioventricular-delay
#14
Daniel Rodríguez Muñoz, José Luis Moya Mur, Javier Moreno, Covadonga Fernández-Golfín, Eduardo Franco, Bostjan Berlot, Juan Manuel Monteagudo, Roberto Matía Francés, Antonio Hernández Madrid, José Luis Zamorano
BACKGROUND: Flow entering the left ventricle is reversed toward the outflow tract through rotating reversal flow around the mitral valve. This was thought to facilitate early ejection, but had not been proved to date. We hypothesized that perfect coupling between reversal and ejection flow would occur at optimal atrioventricular delay (AVD), contributing to its hemodynamic superiority, and evaluated its applicability for AVD optimization. METHODS AND RESULTS: Forty consecutive patients with cardiac resynchronization therapy underwent intracardiac flow analysis and AVD optimization...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28496934/catheter-ablation-for-persistent-and-long-standing-persistent-atrial-fibrillation
#15
REVIEW
Martin Fiala
Persistent and long-standing persistent atrial fibrillation evolves from complex arrhythmogenic substrate and sources. Multiple studies have shown improved freedom from arrhythmia recurrences if sinus rhythm had been restored during the index ablation; however, such harder procedural endpoint requires laborious stepwise approach almost invariably pursuing non-pulmonary-vein sources. Longer-term conversion of persistent atrial fibrillation into sinus rhythm is associated with significant improvement in major indices of hemodynamic and functional status; these indices also represent major predictors of cardiovascular mortality...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28491863/reproducing-patient-specific-hemodynamics-in-the-blalock-taussig-circulation-using-a-flexible-multi-domain-simulation-framework-applications-for-optimal-shunt-design
#16
Christopher J Arthurs, Pradyumn Agarwal, Anna V John, Adam L Dorfman, Ronald G Grifka, C Alberto Figueroa
For babies born with hypoplastic left heart syndrome, several open-heart surgeries are required. During Stage I, a Norwood procedure is performed to construct an appropriate circulation to both the systemic and the pulmonary arteries. The pulmonary arteries receive flow from the systemic circulation, often using a Blalock-Taussig (BT) shunt between the innominate artery and the right pulmonary artery. This procedure causes significantly disturbed flow in the pulmonary arteries. In this study, we use computational hemodynamic simulations to demonstrate its capacity for examining the properties of the flow through and near the BT shunt...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28479514/comprehensive-use-of-cardiac-computed-tomography-to-guide-left-ventricular-lead-placement-in-cardiac-resynchronization-therapy
#17
Jonathan M Behar, Ronak Rajani, Amir Pourmorteza, Rebecca Preston, Orod Razeghi, Steve Niederer, Shaumik Adhya, Simon Claridge, Tom Jackson, Ben Sieniewicz, Justin Gould, Gerry Carr-White, Reza Razavi, Elliot McVeigh, Christopher Aldo Rinaldi
BACKGROUND: Optimal lead positioning is an important determinant of cardiac resynchronization therapy (CRT) response. OBJECTIVE: Evaluation of cardiac computed tomography (CT) selection of the optimal epicardial vein for LV lead placement by targeting regions of late mechanical activation (LMA) and avoiding myocardial scar. METHODS: 18 patients undergoing CRT upgrade with existing pacing systems, underwent pre-implant ECG-gated cardiac CT to assess wall thickness, hypoperfusion, LMA and regions of myocardial scar by the derivation of the Stretch Quantifier of Endocardial Engraved Zones (SQUEEZ) algorithm...
May 4, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28478877/microvascular-fluid-resuscitation-in-circulatory-shock
#18
REVIEW
Shannan K Hamlin, Penelope Z Strauss, Hsin-Mei Chen, LaDonna Christy
The microcirculation is responsible for blood flow regulation and red blood cell distribution throughout individual organs. Patients with circulatory shock have acute failure of the cardiovascular system in which there is insufficient delivery of oxygen to meet metabolic tissue requirements. All subtypes of shock pathophysiology have a hypovolemic component. Fluid resuscitation guided by systemic hemodynamic end points is a common intervention. Evidence shows that microcirculatory shock persists even after optimization of macrocirculatory hemodynamics...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28476919/v%C3%AC-o2-kinetics-associated-with-moderate-intensity-exercise-in-heart-failure-impact-of-intrathecal-fentanyl-inhibition-of-group-iii-iv-locomotor-muscle-afferents
#19
Erik H Van Iterson, Bruce D Johnson, Michael J Joyner, Timothy B Curry, Thomas P Olson
Heart failure (HF) patients demonstrate impaired pulmonary, circulatory, and nervous system responses to exercise. While HF demonstrate prolonged (time-constant, τ) pulmonary oxygen uptake (V̇O2) on-kinetics contributing to exercise intolerance, it is unknown if abnormal V̇O2 kinetics couple with ventilatory and circulatory dysfunction secondary to impaired group III/IV afferents in HF. Because lower-lumbar intrathecal fentanyl inhibits locomotor muscle afferents resulting in improved exercise ventilation and hemodynamics, we tested the hypotheses, HF will demonstrate: 1) rapid V̇O2 on-kinetics, and 2) attenuated steady-state V̇O2 amplitude and oxygen deficit (O2def) during exercise with fentanyl versus placebo...
May 5, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28471371/the-reversal-of-direct-oral-anticoagulants-in-animal-models
#20
Markus Honickel, Necib Akman, Oliver Grottke
Several direct oral anticoagulants (DOACs), including direct thrombin and factor Xa inhibitors, have been approved as alternatives to vitamin K antagonist (VKA) anticoagulants. As with any anticoagulant, DOAC use carries a risk of bleeding. In patients with major bleeding or needing urgent surgery, reversal of DOAC anticoagulation may be required, presenting a clinical challenge. The optimal strategy for DOAC reversal is being refined, and may include use of hemostatic agents such as prothrombin complex concentrates (PCCs; a source of concentrated clotting factors), or DOAC-specific antidotes (which bind their target DOAC to abrogate its activity)...
April 4, 2017: Shock
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