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https://www.readbyqxmd.com/read/28592589/right-heart-end-systolic-remodeling-index-strongly-predicts-outcomes-in-pulmonary-arterial-hypertension-comparison-with-validated-models
#1
COMPARATIVE STUDY
Myriam Amsallem, Andrew J Sweatt, Marie C Aymami, Tatiana Kuznetsova, Mona Selej, HongQuan Lu, Olaf Mercier, Elie Fadel, Ingela Schnittger, Michael V McConnell, Marlene Rabinovitch, Roham T Zamanian, Francois Haddad
BACKGROUND: Right ventricular (RV) end-systolic dimensions provide information on both size and function. We investigated whether an internally scaled index of end-systolic dimension is incremental to well-validated prognostic scores in pulmonary arterial hypertension. METHODS AND RESULTS: From 2005 to 2014, 228 patients with pulmonary arterial hypertension were prospectively enrolled. RV end-systolic remodeling index (RVESRI) was defined by lateral length divided by septal height...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28550606/renal-injury-in-pediatric-anorexia-nervosa-a-retrospective-study
#2
Chantal Stheneur, Sebastien J Bergeron, Jean-Yves Frappier, Olivier Jamoulle, Danielle Taddeo, Marc Sznajder, Anne-Laure Lapeyraque
PURPOSE: Although primarily a mental health disorder, anorexia nervosa (AN) has many physical consequences. Among them, the consequences on kidney function are often underestimated. We evaluated renal function in adolescent AN inpatients and investigated the correlation between the GFR and intrinsic patient characteristics. METHODS: A single-center retrospective study was conducted on 51 patients hospitalized for the restrictive type of AN in 2013. Data were divided into: (1) medical history of AN; (2) growth parameters and vital signs upon admission; and (3) blood tests...
May 26, 2017: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/28546143/patients-with-light-chain-al-amyloidosis-and-low-free-light-chain-burden-have-distinct-clinical-features-and-outcome
#3
Paolo Milani, Marco Basset, Francesca Russo, Andrea Foli, Giampaolo Merlini, Giovanni Palladini
The validated criteria of hematologic response in AL amyloidosis are based on the measurement of circulating free light chains (FLC). Patients with a difference between involved and uninvolved FLC (dFLC) <50 mg/L cannot be assessed for response and are excluded from clinical trials. We compared the clinical characteristics and outcome of 203 newly diagnosed patients with dFLC<50 mg/L (low-dFLC) with 866 patients with measurable dFLC (high-dFLC), evaluated between 2004 and 2015. Heart involvement was significantly less common and less advanced in the low-dFLC group (43% vs...
May 25, 2017: Blood
https://www.readbyqxmd.com/read/28487868/severe-symptomatic-acute-hyponatremia-in-traumatic-brain-injury-responded-very-rapidly-to-a-single-15-mg-dose-of-oral-tolvaptan-a-mayo-clinic-health-system-hospital-experience-need-for-caution-with-tolvaptan-in-younger-patients-with-preserved-renal-function
#4
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Tolvaptan is now well established as a potent pharmaceutical agent for symptomatic hyponatremia from syndrome of inappropriate antidiuretic hormone secretion (SIADH), congestive heart failure and liver cirrhosis. Previous studies had recruited older (63-65 years) patients with mild renal impairment (serum creatinine, 1.3-1.4 mg/dl). A 2012 report in the Journal of Neurology, Neurosurgery & Psychiatry described tolvaptan as a "lifesaving drug". A major outcome concern in the treatment of chronic hyponatremia is potentially fatal pontine demyelination from over-rapid correction of serum sodium >0...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28473036/ethical-analysis-of-withdrawing-total-artificial-heart-support
#5
Erin S DeMartino, Sara E Wordingham, John M Stulak, Barry A Boilson, Kayla R Fuechtmann, Nausheen Singh, Daniel P Sulmasy, Octavio E Pajaro, Paul S Mueller
OBJECTIVES: To describe the characteristics of patients who undergo withdrawal of total artificial heart support and to explore the ethical aspects of withdrawing this life-sustaining treatment. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all adult recipients of a total artificial heart at Mayo Clinic from the program's inception in 2007 through June 30, 2015. Management of other life-sustaining therapies, approach to end-of-life decision making, engagement of ethics and palliative care consultation, and causes of death were analyzed...
May 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28457559/periodic-limb-movements-of-sleep-are-associated-with-an-increased-prevalence-of-atrial-fibrillation-in-patients-with-mild-sleep-disordered-breathing
#6
Jiang Xie, C Anwar A Chahal, Naima Covassin, Phillip J Schulte, Prachi Singh, Narat Srivali, Virend K Somers, Sean M Caples
BACKGROUND: Growing evidence indicates that periodic limb movements of sleep (PLMS) may be related to increased risk of developing cardiovascular disease. However, the association of PLMS with atrial fibrillation (AF) is unclear, especially in patients with sleep-disordered breathing (SDB). This study sought to investigate whether PLMS were associated with increased AF prevalence, independent of established risk factors. METHODS: We performed a cross-sectional study of patients who underwent attended polysomnography at Mayo Clinic from 2011 to 2014...
April 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28454826/outcomes-in-adult-fontan-patients-with-atrial-tachyarrhythmias
#7
Alexander C Egbe, Heidi M Connolly, Arooj R Khan, Talha Niaz, Sameh S Said, Joseph A Dearani, Carole A Warnes, Abhishek J Deshmukh, Suraj Kapa, Christopher J McLeod
BACKGROUND: The optimal management strategy for atrial tachyarrhythmia in the Fontan population is unknown. METHODS: Retrospective review of 264 adult Fontan patients with atrial tachyarrhythmia evaluating 3 clinically adopted scenarios: antiarrhythmic drug (AAD) therapy, catheter ablation (CA), and Fontan conversion (FC). These patients were followed up at Mayo Clinic from 1994 to 2014. The study objective was to compare freedom from atrial tachyarrhythmia recurrence (AR) and occurrence of composite adverse events (stroke, heart failure hospitalization, death, or heart transplant) between treatment groups...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28356300/reassessing-phase-ii-heart-failure-clinical-trials-consensus-recommendations
#8
Javed Butler, Carine E Hamo, James E Udelson, Christopher O'Connor, Hani N Sabbah, Marco Metra, Sanjiv J Shah, Dalane W Kitzman, John R Teerlink, Harold S Bernstein, Gabriel Brooks, Christophe Depre, Mary M DeSouza, Wilfried Dinh, Mark Donovan, Regina Frische-Danielson, Robert J Frost, Dahlia Garza, Udo-Michael Gohring, Jennifer Hellawell, Judith Hsia, Shiro Ishihara, Patricia Kay-Mugford, Joerg Koglin, Marc Kozinn, Christopher J Larson, Martha Mayo, Li-Ming Gan, Pierrre Mugnier, Sekayi Mushonga, Lothar Roessig, Cesare Russo, Afshin Salsali, Carol Satler, Victor Shi, Barry Ticho, Michael van der Laan, Clyde Yancy, Norman Stockbridge, Mihai Gheorghiade
The increasing burden and the continued suboptimal outcomes for patients with heart failure underlines the importance of continued research to develop novel therapeutics for this disorder. This can only be accomplished with successful translation of basic science discoveries into direct human application through effective clinical trial design and execution that results in a substantially improved clinical course and outcomes. In this respect, phase II clinical trials play a pivotal role in determining which of the multitude of potential basic science discoveries should move to the large and expansive registration trials in humans...
April 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28290973/total-artificial-heart-implantation-as-a-bridge-to-heart-transplantation-in-an-active-duty-service-member-with-amyloid-cardiomyopathy
#9
Michael S Scully, Dylan E Wessman, James M McKee, Gregory M Francisco, Keshav R Nayak, Jon A Kobashigawa
INTRODUCTION: Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28284501/cardiopulmonary-exercise-test-in-adults-with-prior-fontan-operation-the-prognostic-value-of-serial-testing
#10
Alexander C Egbe, David J Driscoll, Arooj R Khan, Sameh S Said, Emmanuel Akintoye, Fernando M Berganza, Heidi M Connolly
BACKGROUND: The purpose of the study was to determine the role of cardiopulmonary exercise test (CPET) indices in predicting cardiovascular adverse events (CAEs) in patients with Fontan palliation. CAE was defined as death or cardiac surgery. METHODS: Retrospective review of adult Fontan patients who had treadmill CPET at Mayo Clinic, 1994-2013. Patients with loss of follow-up defined as ≥2years without clinical follow-up were excluded. The results of serial CPETs were reviewed, and patients with CPETs meeting the following criteria were selected for analysis: maximum effort on serial CPETs, minimum of 3-year interval between CPETs, and absence of CAE between CPETs...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28279033/-analysis-of-clinical-characteristics-and-outcome-of-patients-with-very-high-risk-primary-immunoglobulin-light-chain-amyloidosis
#11
J Feng, X F Huang, C L Zhang, K N Shen, C L Zhang, J Sun, Z Tian, X X Cao, L Zhang, D B Zhou, J Li
Objective: To evaluate the clinical characteristics and outcomes of very high risk patients with primary immunoglobulin light-chain amyloidosis (pAL) at a single center in China. Method: Clinical data, treatment and outcome of 205 pAL patients in Peking Union Medical College Hospital from January 2009 to February 2016 were retrospectively analyzed. A 'very high risk' group includes patients with Mayo 2004 stage Ⅲb and Mayo 2012 stage 4. Results: Of 205 patients, 34 (16.6%) were defined as very high risk pAL patients...
February 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/28262200/outcomes-of-direct-current-cardioversion-in-adults-with-congenital-heart-disease
#12
Alexander C Egbe, Samuel J Asirvatham, Heidi M Connolly, Suraj Kapa, Christopher V Desimone, Vaibhav R Vaidya, Abhishek J Deshmukh, Arooj R Khan, Christopher J McLeod, Rowlens M Melduni, Naser M Ammash
Few data exist on direct current cardioversion (DCCV) in adult patients with congenital heart disease (CHD). This is a retrospective case-control study of 279 adults with CHD and 279 adults without CHD (control group) who had elective DCCV for atrial arrhythmias at Mayo Clinic, 2001 to 2013. Control patients were matched by gender and arrhythmia type. The objective was to compare DCCV procedural failure (failure to terminate the presenting arrhythmia) and arrhythmia recurrence (AR). In the CHD group (mean age 55 ± 20 years; men 166 [59%]), the most common diagnosis was Fontan palliation (61; 22%)...
May 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28100427/the-possible-role-of-propofol-in-drug-induced-torsades-de-pointes-a-real-world-single-center-analysis
#13
Victor A Abrich, Harish Ramakrishna, Arjun Mehta, Farouk Mookadam, Komandoor Srivathsan
BACKGROUND: Torsades de pointes (TdP) is a polymorphic ventricular tachycardia associated with QT prolongation. Propofol is a sedative-anesthetic with proarrhythmic effects on cardiac myocytes. We performed a retrospective study to determine the incidence of TdP following propofol exposure at Mayo Clinic (Rochester, MN) from 08/11/1998-11/20/2015. METHODS: We queried our database using key search terms to identify patients exposed to propofol who developed TdP perioperatively or during non-surgical sedation...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28089762/long-term-results-of-a-trial-of-concurrent-chemotherapy-and-escalating-doses-of-radiation-for-unresectable-non-small-cell-lung-cancer-ncctg-n0028-alliance
#14
Steven E Schild, Shauna L Hillman, Angelina D Tan, Helen J Ross, William L McGinnis, Yolanda A Garces, David L Graham, Alex A Adjei, James R Jett
INTRODUCTION: This phase I/II trial was designed to determine the maximally tolerated dose of thoracic radiotherapy as part of a combined modality approach. This report includes the long-term outcomes of patients treated on this study. The phase II portion was never completed, as RTOG-0617 opened before it was concluded. METHODS: In this study, the maximally tolerated dose was defined as 74 Gy of radiation in 37 fractions. Twenty-five patients with unresectable NSCLC were treated with 2-Gy daily fractions and concurrent weekly carboplatin and paclitaxel...
April 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28062628/specificity-of-b-type-natriuretic-peptide-assays-cross-reactivity-with-different-bnp-nt-probnp-and-probnp-peptides
#15
Amy K Saenger, Olaia Rodriguez-Fraga, Ranka Ler, Jordi Ordonez-Llanos, Allan S Jaffe, Jens Peter Goetze, Fred S Apple
BACKGROUND: B-type natriuretic peptides (BNPs) are used clinically to diagnose and monitor heart failure and are present in the circulation as multiple proBNP-derived fragments. We investigated the specificity of BNP immunoassays with glycosylated and nonglycosylated BNP, N-terminal proBNP (NT-proBNP), and proBNP peptides to probe the cross-reactivity of each assay. METHODS: Nine B-type natriuretic peptides were studied,including synthetic and recombinant BNP (Shionogi, Scios, Mayo), human and synthetic glycosylated and nonglycosylated NT-proBNP (HyTest, Roche Diagnostics), and human glycosylated and nonglycosylated proBNP (HyTest, Scios)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28011796/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#16
Ammar M Killu, Jae-Yoon Park, Jaskanwal D Sara, David O Hodge, Bernard J Gersh, Rick A Nishimura, Samuel J Asirvatham, Christopher J McLeod
AIMS: A dilated/end-stage phase of hypertrophic cardiomyopathy (HCM) is rare but well-recognized. The role for cardiac resynchronization therapy (CRT) in this subset of patients remains unexplored. We aimed to clarify the impact of bi-ventricular pacing CRT in dilated/end-stage HCM. METHODS AND RESULTS: The Mayo Clinic HCM database was interrogated to identify patients with ejection fraction (EF) <50% and CRT. Control subjects were identified in 1:1 manner...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27951537/association-between-obstructive-sleep-apnea-and-acute-kidney-injury-in-critically-ill-patients-a-propensity-matched-study
#17
Lin Dou, Haitao Lan, Daniel J Reynolds, Tina M Gunderson, Rahul Kashyap, Ognjen Gajic, Sean Caples, Guangxi Li, Kianoush B Kashani
BACKGROUND/AIMS: Obstructive sleep apnea (OSA) is a known risk factor for chronic kidney disease (CKD); however, its association with acute kidney injury (AKI) is not well documented. We aimed to study whether OSA is associated with the risk of AKI in the intensive care unit (ICU) setting. METHODS: All consecutive adult Olmsted County, MN residents who were admitted in Mayo Clinic ICUs from January 1, 2010 to December 31, 2010 were screened. Chronic and acute risk factors were collected within the first 48 h of ICU admission...
2017: Nephron
https://www.readbyqxmd.com/read/27933393/prevalence-and-prognostic-impact-of-left-sided-valve-thickening-in-systemic-light-chain-amyloidosis
#18
Dania Mohty, Sarah Pradel, Julien Magne, Bahaa Fadel, Cyrille Boulogne, Vincent Petitalot, Safaa Raboukhi, Nicole Darodes, Thibaud Damy, Victor Aboyans, Arnaud Jaccard
BACKGROUND: Left heart valve thickening (LVT) was described in patients with light-chain amyloidosis (AL). This phenomenon reflects likely infiltration of the valve by amyloid proteins. However, the prevalence of LVT and its prognostic value have not been investigated in patients with AL. METHODS AND RESULTS: Comprehensive transthoracic echocardiography was performed at baseline in 150 patients [median age 68 (33-87) years; 59% male] with confirmed AL. The presence of abnormal mitral and/or aortic valve thickening (>3 mm) was assessed in all included patients...
December 8, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27916154/cancer-history-portends-worse-acute-and-long-term-noncardiac-but-not-cardiac-mortality-after-primary-percutaneous-coronary-intervention-for-acute-st-segment-elevation-myocardial-infarction
#19
Feilong Wang, Rajiv Gulati, Ryan J Lennon, Bradley R Lewis, Jae Park, Gurpreet S Sandhu, R Scott Wright, Amir Lerman, Joerg Herrmann
OBJECTIVE: To define the effect of a history of cancer on in-hospital and long-term mortality after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). PATIENTS AND METHODS: In this retrospective cohort study of 2346 patients with STEMI enrolled in the Mayo Clinic PCI registry from November 1, 2000, through October 31, 2010, we identified 261 patients (11.1%) with a history of cancer. The in-hospital and long-term outcomes (median follow-up, 6...
December 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27893194/incidence-morphology-and-progression-of-bicuspid-aortic-valve-in-pediatric-and-young-adult-subjects-with-coexisting-congenital-heart-defects
#20
Talha Niaz, Joseph T Poterucha, Jonathan N Johnson, Cecilia Craviari, Thomas Nienaber, Jared Palfreeman, Frank Cetta, Donald J Hagler
BACKGROUND: Bicuspid aortic valve (BAV) occurs both as an isolated cardiac lesion and in association with congenital heart defects (CHD). Their aim was to identify the incidence and morphology of BAV in patients with coexisting CHD and compare their disease progression to patients with isolated BAV. METHODS: The Mayo Clinic echocardiography database was retrospectively analyzed to identify pediatric and young adult patients (≤22 years) who were diagnosed with BAV from 1990 to 2015...
November 28, 2016: Congenital Heart Disease
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