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Right ventricular decompensation

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https://www.readbyqxmd.com/read/28285867/a-modified-lung-and-cardiac-ultrasound-protocol-saves-time-and-rules-in-the-diagnosis-of-acute-heart-failure
#1
Frances M Russell, Robert R Ehrman
BACKGROUND: Multiorgan ultrasound (US), which includes evaluation of the lungs and heart, is an accurate method that outperforms clinical gestalt for diagnosing acutely decompensated heart failure (ADHF). A known barrier to ultrasound use is the time needed to perform these examinations. OBJECTIVE: The primary goal of this study was to determine the test characteristics of a modified lung and cardiac US (LuCUS) protocol for the accurate diagnosis of ADHF. METHODS: This was a secondary analysis of a prospective observational study that enrolled adult patients presenting to the emergency department with undifferentiated dyspnea...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#2
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28188427/the-prognostic-value-of-right-ventricular-long-axis-strain-in-non-ischaemic-dilated-cardiomyopathies-using-standard-cardiac-magnetic-resonance-imaging
#3
Nisha Arenja, Johannes H Riffel, Manuel Halder, Charly N Djiokou, Thomas Fritz, Florian Andre, Fabian Aus dem Siepen, Thomas Zelniker, Benjamin Meder, Elham Kayvanpour, Grigorios Korosoglou, Hugo A Katus, Sebastian J Buss
OBJECTIVE: To investigate the association of right ventricular long axis strain (RV-LAS), a parameter of longitudinal function, with outcome in patients with non-ischaemic dilated cardiomyopathy (NIDCM). METHODS: In 441 patients with NIDCM, RV-LAS was analysed retrospectively by measuring the length between the epicardial border of the left ventricular apex and the middle of a line connecting the origins of the tricuspidal valve leaflets in end-diastole and end-systole on non-contrast standard cine sequences...
February 10, 2017: European Radiology
https://www.readbyqxmd.com/read/28159812/right-ventricular-metabolism-during-veno-arterial-extracorporeal-membrane-oxygenation-in-immature-swine-heart-in-vivo
#4
Masaki Kajimoto, Dolena R Ledee, Nancy G Isern, Michael A Portman
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides hemodynamic rescue for patients encountering right or left ventricular (RV or LV) decompensation, particularly after surgery for congenital heart defects. ECMO, supported metabolically by parenteral nutrition, provides reductions in myocardial work and energy demand and therefore enhances functional recovery. The RV must often assume systemic ventricular pressures and function upon weaning from VA-ECMO. However the substrate utilization responses of the RV to VA-ECMO or stimulation are unknown...
February 3, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28109578/liver-fibrogenesis-marker-7s-domain-of-collagen-type-iv-in-patients-with-acutely-decompensated-heart-failure-correlates-prognostic-value-and-time-course
#5
Kazuya Nagao, Akinori Tamura, Takeshi Morimoto, Kiyotaka Shimamura, Hiroshi Yukawa, Haruyasu Ito, Fujio Hayashi, Toshinori Makita, Genzou Takemura, Yukihito Sato, Tsukasa Inada, Takeshi Kimura, Masaru Tanaka
BACKGROUND: Congestion in heart failure (HF) induces multiple organ injury, which may cause remodeling of extracellular matrix. We hypothesized that liver fibrogenesis marker, 7S domain of collagen type IV (P4NP 7S) was correlated with congestion and liver injury in HF. METHODS AND RESULTS: We measured serum P4NP 7S in two cohorts. Cohort 1 included 70 patients undergoing catheterization. P4NP 7S was correlated with pulmonary capillary wedge pressure, right ventricular and atrial pressure (r=0...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#6
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28040759/novel-application-of-a-percutaneous-left-ventricular-assist-device-as-a-bridge-to-transplant-in-a-paediatric-patient-with-severe-heart-failure-due-to-viral-myocarditis
#7
Paul Perry, Elizabeth David, Broadus Atkins, Gary Raff
A 13-year obese female with suspected viral myocarditis presented with acute decompensated heart failure. Due to her body habitus, she was a poor candidate for immediate heart transplantation. A peripherally inserted left ventricular assist device (LVAD) was implanted via the right axillary artery. Following device insertion the patient experienced rapid improvement in symptoms. The LVAD provided effective left ventricular unloading for 50 days, promoting myocardial recovery and maintaining excellent patient performance status...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27870971/modes-of-death-in-patients-with-heart-failure-and-preserved-ejection-fraction
#8
Stefan Aschauer, Caroline Zotter-Tufaro, Franz Duca, Andreas Kammerlander, Daniel Dalos, Julia Mascherbauer, Diana Bonderman
BACKGROUND: Recent studies suggest that reduced right ventricular function is an important predictor of outcome in patients with heart failure and preserved ejection fraction (HFpEF). Because affected patients suffer from a broad spectrum of non-cardiac co-morbidities, it remains unclear, whether they actually die from right heart failure (RHF) or as a consequence of other conditions. METHODS: Consecutive patients with a confirmed diagnosis of HFpEF were enrolled in this prospective registry...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27844194/-implantable-sensors-for-outpatient-assessment-of-ventricular-filling-pressure-in-advanced-heart-failure-which-telemonitoring-design-is-optimal
#9
E Herrmann, S Fichtlscherer, S H Hohnloser, A M Zeiher, B Aßmus
INTRODUCTION: Patients with advanced heart failure suffer from frequent hospitalizations. Non-invasive hemodynamic telemonitoring for assessment of ventricular filling pressure has been shown to reduce hospitalizations. We report on the right ventricular (RVP), the pulmonary artery (PAP) and the left atrial pressure (LAP) sensor for non-invasive assessment of the ventricular filling pressure. METHODS: A literature search concerning the available implantable pressure sensors for noninvasive haemodynamic telemonitoring in patients with advanced heart failure was performed...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27818380/novel-minimally-invasive-surgical-approach-using-an-external-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock
#10
Koji Takeda, Arthur R Garan, Veli K Topkara, Ajay J Kirtane, Dimitri Karmpaliotis, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Hiroo Takayama
OBJECTIVES: The use of short-term mechanical circulatory support (MCS) has increased in the treatment of refractory cardiogenic shock (RCS). Percutaneous short-term MCS technology has emerged rapidly; however, limitations in flow and durability remain. We therefore investigated a minimally invasive surgical approach using an external ventricular assist device (VAD) and extracorporeal membrane oxygenation (ECMO) in patients with RCS. METHODS: Twenty-five patients underwent minimally invasive external VAD insertion with a magnetically levitated centrifugal pump for various causes of cardiogenic shock between April 2010 and May 2016...
November 6, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27784446/-effect-of-50-mg-alteplase-to-intermediate-risk-pulmonary-embolism-with-right-ventricular-dysfunction
#11
Q H Xu, W L Li, Z M Cai, Y C Lin, S P Huang
Objective: To investigate the effect of 50 mg alteplase to intermediate-risk acute pulmonary embolism (APE) with right ventricular dysfunction. Methods: From May 2011 to May 2015, a total of 73 patients with intermediate-risk APE, furthermore, right ventricular systolic pressure (RVSP)>40 mmHg and B-type natriuretic peptide (BNP)>100 ng/L, were allocated to receive 50 mg alteplase plus anti-coagulation (thrombolysis group, TG, n=35) or anticoagulation alone (control group CG, n=38) according to their will...
October 18, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27777699/tetralogy-of-fallot-and-pheochromocytoma-in-a-situs-inversus-totalis-an-unusual-association
#12
Rubén Kevin Arnold Tapia-Orihuela, Jorge Huaringa-Marcelo, David Loja-Oropeza
Introduction: Situs inversus totalis is an uncommon anomaly which exist a complete transposition of organs and it's occasionally associated with congenital heart diseases, such as tetralogy of fallot. Pheochromocytoma is a rare neuroendocrine tumor with an annual incidence of 2-8 cases per million people and for years has been studied its relationship with the hypoxic pathway. Case Report: A 29 year old male with a history of tetralogy of fallot corrected at 10 years and situs inversus totalis. He was admitted to hospital with a progressive story of four months of constipation, palpitations, headache, dyspnea and sweating...
2016: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/27774265/ventricular-conduction-abnormalities-as-predictors-of-long-term-survival-in-acute-de-novo-and-decompensated-chronic-heart-failure
#13
Heli Tolppanen, Krista Siirila-Waris, Veli-Pekka Harjola, David Marono, Jiri Parenica, Philipp Kreutzinger, Tuomo Nieminen, Marie Pavlusova, Tuukka Tarvasmaki, Raphael Twerenbold, Jukka Tolonen, Roman Miklik, Markku S Nieminen, Jindrich Spinar, Christian Mueller, Johan Lassus
AIMS: Data on the prognostic role of left and right bundle branch blocks (LBBB and RBBB), and nonspecific intraventricular conduction delay (IVCD; QRS ≥ 110 ms, no BBB) in acute heart failure (AHF) are controversial. Our aim was to investigate electrocardiographic predictors of long-term survival in patients with de novo AHF and acutely decompensated chronic heart failure (ADCHF). METHODS AND RESULTS: We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3...
March 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27760781/biomarkers-for-clinical-decision-making-in-the-management-of-pulmonary-embolism
#14
REVIEW
Evangelos Giannitsis, Hugo A Katus
BACKGROUND: Pulmonary embolism (PE) is associated with high all-cause and PE-related mortality and requires individualized management. After confirmation of PE, a refined risk stratification is particularly warranted among normotensive patients. Previous prognostic models favored combinations of echocardiography or computed tomography suggestive of right ventricular (RV) dysfunction together with biomarkers of RV dysfunction (natriuretic peptides) or myocardial injury (cardiac troponins) to identify candidates for thrombolysis or embolectomy...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27750131/exercise-training-effects-on-elderly-and-middle-age-patients-with-chronic-heart-failure-after-acute-decompensation-a-randomized-controlled-trial
#15
Domenico Acanfora, Pietro Scicchitano, Gerardo Casucci, Bernardo Lanzillo, Nicola Capuano, Giuseppe Furgi, Chiara Acanfora, Marialaura Longobardi, Raffaele Antonelli Incalzi, Giuseppe Piscosquito, Marco Matteo Ciccone
BACKGROUND: The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. METHODS: This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) <40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27660567/using-the-minimally-invasive-impella-5-0-via-the-right-subclavian-artery-cutdown-for-acute-on-chronic-decompensated-heart-failure-as-a-bridge-to-decision
#16
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27626325/chronic-hypobaric-hypoxia-induces-right-ventricular-hypertrophy-and-apoptosis-in-rats-therapeutic-potential-of-nanocurcumin-in-improving-adaptation
#17
Sarita Nehra, Varun Bhardwaj, Santosh Kar, Deepika Saraswat
Nehra, Sarita, Varun Bhardwaj, Santosh Kar, and Deepika Saraswat. Chronic hypobaric hypoxia induces right ventricular hypertrophy and apoptosis in rats: therapeutic potential of nanocurcumin in improving adaptation. High Alt Med Biol. 17:342-352, 2016.-a sustained work load on the right heart on ascent to high altitudes promotes right ventricular hypertrophy (RVH), which eventually undergoes decompensation and promotes pathological damage. However, the exact set of events leading to damage remains unidentified...
December 2016: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27586549/b-type-natriuretic-peptide-powerful-predictor-of-end-stage-chronic-heart-failure-in-individuals-with-systolic-dysfunction-of-the-systemic-right-ventricle
#18
Marketa Hegarova, Jaroslav Brotanek, Milos Kubanek, Radka Kockova, Janka Franekova, Vera Lanska, Ivan Netuka, Vojtech Melenovsky, Ivan Malek, Josef Kautzner
AIM: To assess whether B-type natriuretic peptide (BNP) can serve as a predictor of end-stage chronic heart failure (CHF) in patients with severe systolic dysfunction of the systemic right ventricle (SRV). METHODS: We performed a retrospective analysis in 28 patients with severe systolic dysfunction of the SRV (ejection fraction 23 ± 6%) who were evaluated as heart transplant (HTx) candidates between May 2007 and October 2014. The primary endpoints of the study (end-stage CHF) were progressive CHF, urgent HTx, and ventricular assist device (VAD) implantation...
August 31, 2016: Croatian Medical Journal
https://www.readbyqxmd.com/read/27545308/percutaneous-closure-of-acute-aorto-right-ventricular-fistula-following-transcatheter-bicuspid-aortic-valve-replacement
#19
Kenta Nakamura, Jonathan J Passeri, Ignacio Inglessis-Azuaje
We report a case of acute aorto-right ventricular fistula following transcatheter bicuspid aortic valve replacement and subsequent percutaneous closure. The diagnosis and treatment of this rare complication is illustrated through multi-modality imaging. We hypothesize that the patient's heavily calcified bicuspid aortic valve anatomy led to asymmetric deployment of the transcatheter aortic valve replacement (TAVR) prosthesis, traumatizing the right sinus of Valsalva at the distal edge of the TAVR stent and ultimately fistulized to the right ventricle...
August 22, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27491800/fatal-cobalt-toxicity-after-total-hip-arthroplasty-revision-for-fractured-ceramic-components
#20
Kimberly A Fox, Todd M Phillips, Joseph H Yanta, Michael G Abesamis
CONTEXT: Post-arthroplasty metallosis, which refers to metallic corrosion and deposition of metallic debris in the periprosthetic soft tissues of the body, is an uncommon complication. Systemic cobalt toxicity post-arthroplasty is extremely rare. The few known fatal cases of cobalt toxicity appear to be a result of replacing shattered ceramic heads with metal-on-metal or metal-on-polyethylene implants. Friction between residual shards of ceramic and cobalt-chromium implants allows release of cobalt into the synovial fluid and bloodstream, resulting in elevated whole blood cobalt levels and potential toxicity...
November 2016: Clinical Toxicology
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