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https://www.readbyqxmd.com/read/28429120/the-influence-of-pump-rotation-speed-on-hemodynamics-and-myocardial-oxygen-metabolism-in-left-ventricular-assist-device-support-with-aortic-valve-regurgitation
#1
Kei Iizuka, Tomohiro Nishinaka, Yoshiaki Takewa, Kenji Yamazaki, Eisuke Tatsumi
Aortic valve regurgitation (AR) is a serious complication under left ventricular assist device (LVAD) support. AR causes LVAD-left ventricular (LV) recirculation, which makes it difficult to continue LVAD support. However, the hemodynamics and myocardial oxygen metabolism of LVAD support with AR have not been clarified, especially, how pump rotation speed influences them. An animal model of LVAD with AR was newly developed, and how pump rotation speed influences hemodynamics and myocardial oxygen metabolism was examined in acute animal experiments...
April 20, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28427554/clinical-and-hemodynamic-improvements-after-adding-ambrisentan-to-background-pde5i-therapy-in-patients-with-pulmonary-arterial-hypertension-exhibiting-a-suboptimal-therapeutic-response-athena-1
#2
Shelley Shapiro, Fernando Torres, Jeremy Feldman, Anne Keogh, Martine Allard, Christiana Blair, Hunter Gillies, James Tislow, Ronald J Oudiz
OBJECTIVE: Pulmonary arterial hypertension (PAH) is a condition which may lead to right ventricular failure and premature death. While recent data supports the initial combination of ambrisentan (a selective ERA) and tadalafil (a PDE5i) in functional class II or III patients, there is no published data describing the safety and efficacy of ambrisentan when added to patients currently receiving a PDE5i and exhibiting a suboptimal response. The ATHENA-1 study describes the safety and efficacy of the addition of ambrisentan in this patient population...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28417594/real-world-supported-unprotected-left-main-percutaneous-coronary-intervention-with-impella-device-data-from-the-uspella-registry
#3
Theodore Schreiber, Wah Wah Htun, Nimrod Blank, Tesfaye Telila, Nestor Mercado, Alexandros Briasoulis, Amir Kaki, Ashok Kondur, Ahmad Munir, Cindy Grines
BACKGROUND: Patients with left main (LM) coronary artery disease are increasingly being treated with percutaneous revascularization (PCI). The safety, feasibility, and efficacy of unprotected LM intervention (ULMI) with hemodynamic support by Impella device have not been evaluated previously. OBJECTIVE: Using a large retrospective single center database from the USpella registry, we evaluated the safety, feasibility, and potential benefits of periprocedural left ventricular assist with axial flow Impella 2...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#4
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin, a hormone involved in hemodynamic homeostasis, is controversial in sepsis, since administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma bio-ADM was assessed on days 1, 2 and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of bio-ADM and its time-dependent variation with fluid therapy, vasopressor administration, organ failures and mortality...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28409759/influence-of-central-hemodynamics-on-vv-ecmo-oxygen-delivery-in-neonatal-animal-model
#5
M M Said, O Rivera, G T Mikesell, K Rais-Bahrami
BACKGROUND: Recirculation of oxygenated blood in venovenous extracorporeal membrane oxygenation (VV ECMO) can decrease the oxygen delivery provided by the ECMO support. This study investigated the influence of central hemodynamics and catheter position on the amount of recirculation and oxygen delivery during VV ECMO. METHODS: Recirculation was measured in seven newborn lambs (mean weight 4.7 kg) during VV ECMO using the ELSA Monitor (Transonic Systems, Inc., Ithaca, NY) and using the central venous line (CVL) method...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28407727/randomized-clinical-trial-of-real-time-fmri-amygdala-neurofeedback-for-major-depressive-disorder-effects-on-symptoms-and-autobiographical-memory-recall
#6
Kymberly D Young, Greg J Siegle, Vadim Zotev, Raquel Phillips, Masaya Misaki, Han Yuan, Wayne C Drevets, Jerzy Bodurka
OBJECTIVE: Patients with depression show blunted amygdala hemodynamic activity to positive stimuli, including autobiographical memories. The authors examined the therapeutic efficacy of real-time functional MRI neurofeedback (rtfMRI-nf) training aimed at increasing the amygdala's hemodynamic response to positive memories in patients with depression. METHOD: In a double-blind, placebo-controlled, randomized clinical trial, unmedicated adults with depression (N=36) were randomly assigned to receive two sessions of rtfMRI-nf either from the amygdala (N=19) or from a parietal control region not involved in emotional processing (N=17)...
April 14, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28406814/pilot-feasibility-study-of-therapeutic-hypothermia-for-moderate-to-severe-acute-respiratory-distress-syndrome
#7
Donald F Slack, Douglas S Corwin, Nirav G Shah, Carl B Shanholtz, Avelino C Verceles, Giora Netzer, Kevin M Jones, Clayton H Brown, Michael L Terrin, Jeffrey D Hasday
OBJECTIVES: Prior studies suggest hypothermia may be beneficial in acute respiratory distress syndrome, but cooling causes shivering and increases metabolism. The objective of this study was to assess the feasibility of performing a randomized clinical trial of hypothermia in patients with acute respiratory distress syndrome receiving treatment with neuromuscular blockade because they cannot shiver. DESIGN: Retrospective study and pilot, prospective, open-label, feasibility study...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28406724/fifty-years-of-research-in-ards-gas-exchange-in-acute-respiratory-distress-syndrome
#8
Peter Radermacher, Salvatore Maurizio Maggiore, Alain Mercat
The acute respiratory distress syndrome (ARDS) is characterized by severe impairment of gas exchange. Hypoxemia is mainly due to intrapulmonary shunt, while increased alveolar dead space explains the alteration of CO2 clearance. Assessment of the severity of gas exchange impairment is a requisite for the characterization of the syndrome and the evaluation of its severity. Confounding factors linked to hemodynamic status can greatly influence the relationship between the severity of lung injury and the degree of hypoxemia and/or the effects of ventilator settings on gas exchange...
April 13, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28405091/ambulatory-extracorporeal-membrane-oxygenation-with-subclavian-venoarterial-cannulation-to-increase-mobility-and-recovery-in-a-patient-awaiting-cardiac-transplantation
#9
Samuel Jacob, Juan C MacHannaford, Themistokles Chamogeorgakis, Gonzalo V Gonzalez-Stawinski, Joost Felius, Aldo E Rafael, Rajasekhar S Malyala, Brian Lima
Venoarterial extracorporeal membrane oxygenation (ECMO) can provide temporary cardiopulmonary support for patients in hemodynamic extremis or refractory heart failure until more durable therapies-such as cardiac transplantation or a left ventricular assist device-can be safely implemented. Conventional ECMO cannulation strategies commonly employ the femoral artery and vein, constraining the patients to the supine position for the duration of ECMO support. We have recently adopted a modified cannulation approach to promote patient mobility, rehabilitation, and faster recovery and to mitigate complications associated with femoral arterial cannulation, such as limb ischemia and compartment syndrome...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28403210/molecular-adsorbent-recirculating-system-mars-in-acute-liver-injury-and-graft-dysfunction-results-from-a-case-control-study
#10
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Christian Wilms, Anna Hüsing-Kabar, Dennis Görlich, Iyad Kabar, Hartmut H J Schmidt
BACKGROUND: The primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated. AIM: We studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD)...
2017: PloS One
https://www.readbyqxmd.com/read/28400904/extensive-mobile-thrombus-of-the-internal-carotid-discovered-after-intravenous-thrombolysis-what-do-i-do-now
#11
Eugene L Scharf, Jennifer E Fugate, Sara E Hocker
This case report describes a rare presentation of ischemic stroke secondary to an extensive internal carotid artery thrombus, subsequent therapeutic dilemma, and clinical management. A 58-year-old man was administered intravenous (IV) thrombolysis for right middle cerebral artery territory ischemic stroke symptoms. A computed tomography angiogram of the head and neck following thrombolysis showed a longitudinally extensive internal carotid artery thrombus originating at the region of high-grade calcific stenosis...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28398949/sildenafil-possible-prophylaxis-against-swimming-induced-pulmonary-edema-sipe
#12
Stefanie D Martina, John J Freiberger, Dionne F Peacher, Michael J Natoli, Eric A Schinazi, Dawn N Kernagis, Jennifer Av Potter, Claire E Otteni, Richard E Moon
Swimming-induced pulmonary edema (SIPE) occurs during swimming and scuba diving, usually in cold water, in susceptible healthy individuals, especially military recruits and triathletes. We have previously demonstrated that pulmonary artery pressure (PAP) and pulmonary artery wedge pressure (PAWP) are higher during immersed exercise in SIPE-susceptible individuals vs. controls, confirming that SIPE is a form of hemodynamic pulmonary edema. Oral sildenafil 50 mg 1 hour before immersed exercise reduced PAP and PAWP, suggesting that sildenafil may prevent SIPE...
April 11, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28398362/-the-relationship-between-natriuretic-peptides-and-neprilysin-pathways-the-clinical-simplification-against-the-complexity-of-biological-systems
#13
Giuseppe Di Tano, Aldo Clerico
A large body of evidence supports the use of natriuretic peptides (brain natriuretic peptide [BNP] and N-terminal proBNP [NT-proBNP]) for the evaluation and management of patients with heart failure over time. Elevated values reflect an enhanced counterregulatory response to hemodynamic stress and are indicative of heart failure severity, thus predicting prognosis. The clinical relevance and result interpretation of natriuretic peptides for monitoring therapy are still debated, and our understanding of their complex nature is still far from being complete...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28397410/building-a-better-neonatal-extracorporeal-life-support-circuit-comparison-of-hemodynamic-performance-and-gaseous-microemboli-handling-in-different-pump-and-oxygenator-technologies
#14
Kristen Glass, Payal Trivedi, Shigang Wang, Karl Woitas, Allen R Kunselman, Akif Ündar
Neurologic complications during neonatal extracorporeal life support (ECLS) are associated with significant morbidity and mortality. Gaseous microemboli (GME) in the ECLS circuit may be a possible cause. Advances in neonatal circuitry may improve hemodynamic performance and GME handling leading to reduction in patient complications. This study compared hemodynamic performance and GME handling using two centrifugal pumps (Maquet RotaFlow and Medos Deltastream DP3) and polymethylpentene oxygenators (Maquet Quadrox-iD and Medos Hilite 800LT) in a neonatal ECLS circuit model...
April 2017: Artificial Organs
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#15
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28389621/fluid-shear-induced-cathepsin-b-release-in-the-control-of-mac1-dependent-neutrophil-adhesion
#16
Michael L Akenhead, Shunichi Fukuda, Geert W Schmid-Schönbein, Hainsworth Y Shin
There is compelling evidence that circulatory hemodynamics prevent neutrophil activation, including adhesion to microvessels, in the microcirculation. However, the underlying mechanism or mechanisms by which that mechanoregulation occurs remain unresolved. Here, we report evidence that exposure to fluid shear stress (FSS) promotes neutrophils to release cathepsin B (ctsB) and that this autocrine regulatory event is antiadhesive for neutrophils on endothelial surfaces through Mac1-selective regulation. We used a combined cell-engineering and immunocytochemistry approach to find that ctsB was capable of cleaving Mac1 integrins on neutrophils and demonstrated that this proteolysis alters their adhesive functions...
April 7, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28389079/safety-and-tolerability-of-subcutaneous-treprostinil-in-newborns-with-congenital-diaphragmatic-hernia-and-life-threatening-pulmonary-hypertension
#17
E Carpentier, S Mur, E Aubry, L Pognon, T Rakza, F Flamein, D Sharma, P Tourneux, L Storme
BACKGROUND: Prolonged pulmonary hypertension (PH) is highly predictive for pulmonary morbidity and death in infants with congenital diaphragmatic hernia (CDH). OBJECTIVES: To report the effects and tolerability of subcutaneous treprostinil in newborns with severe CDH and late life-threatening PH. METHODS: We recorded clinical and echocardiography data before and after starting subcutaneous treprostinil, on patients with severe CDH and late PH, refractory to inhaled nitric oxide and oral sildenafil...
March 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28385314/management-of-ventricular-arrhythmias-in%C3%A2-patients-with-advanced-heart-failure
#18
REVIEW
Pasquale Santangeli, J Eduardo Rame, Edo Y Birati, Francis E Marchlinski
Advanced heart failure (A-HF) is characterized by progressive symptoms of heart failure despite optimal therapy. In patients with A-HF, ventricular arrhythmias (VAs) are common. Clinical studies evaluating different therapies to prevent VAs had very limited representation of patients with A-HF. Among antiarrhythmic drugs, only amiodarone reduces VAs, although its use may be associated with increased mortality. Catheter ablation with substrate modification is effective to achieve VA suppression in patients with A-HF, including those with left ventricular assist devices...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28381470/evidence-supporting-the-existence-of-a-distinct-obese-phenotype-of-heart-failure-with-preserved-ejection-fraction
#19
Masaru Obokata, Yogesh N V Reddy, Sorin V Pislaru, Vojtech Melenovsky, Barry A Borlaug
Background -Heart failure (HF) with preserved ejection fraction (HFpEF) is a heterogeneous syndrome. Phenotyping patients into pathophysiologically homogenous groups may enable better targeting of treatment. Obesity is common in HFpEF and has many cardiovascular effects, suggesting it may be a viable candidate for phenotyping. We compared cardiovascular structure, function, and reserve capacity in subjects with obese HFpEF, non-obese HFpEF, and controls. Methods -Subjects with obese HFpEF (BMI≥35kg/m(2), n=99), non-obese HFpEF (BMI<30kg/m(2), n=96), and non-obese controls free of HF (n=71) underwent detailed clinical assessment, echocardiography and invasive hemodynamic exercise testing...
April 5, 2017: Circulation
https://www.readbyqxmd.com/read/28377189/outcomes-of-hemodynamic-support-with-impella-in-very-high-risk-patients-undergoing-balloon-aortic-valvuloplasty-results-from-the-global-cvad-registry
#20
Vikas Singh, Pradeep K Yadav, Marvin H Eng, Francisco Yuri Macedo, Guilherme V Silva, Rodrigo Mendirichaga, Amit P Badiye, Rahul Sakhuja, Sammy Elmariah, Ignacio Inglessis, Carlos E Alfonso, Theodore L Schreiber, Mauricio Cohen, Igor Palacios, William W O'Neill
BACKGROUND: Reports on the role of hemodynamic support devices in patients with severe aortic stenosis (AS) and left ventricular (LV) dysfunction undergoing balloon aortic valvuloplasty (BAV) are limited. METHODS: Patients were identified from the cVAD registry, an ongoing multicenter voluntary registry at selected sites in North America that have used Impella in >10 patients. RESULTS: A total of 116 patients with AS who underwent BAV with Impella support were identified...
March 22, 2017: International Journal of Cardiology
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