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Michel Komajda
Ivabradine is a blocker of the funny current channels in the sinoatrial node cells. This results in pure heart rate reduction when elevated without direct effect on contractility or on the vessels. It was tested in a large outcome clinical trial in stable chronic heart failure (CHF) with low ejection fraction, in sinus rhythm, on a contemporary background therapy including betablockers (SHIFT: Systolic Heart Failure Treatment with the If inhibitor Trial).The primary composite endpoint (cardiovascular mortality or heart failure hospitalization) was reduced by 18% whereas the first occurrence of heart failure hospitalizations was reduced by 26%...
October 18, 2016: Handbook of Experimental Pharmacology
L T Burgers, W K Redekop, M J Al, S K Lhachimi, N Armstrong, S Walker, C Rothery, M Westwood, J L Severens
AIMS: New generation dual-source coronary CT (NGCCT) scanners with more than 64 slices were evaluated for patients with (known) or suspected of coronary artery disease (CAD) who are difficult to image: obese, coronary calcium score > 400, arrhythmias, previous revascularization, heart rate > 65 beats per minute, and intolerance of betablocker. A cost-effectiveness analysis of NGCCT compared with invasive coronary angiography (ICA) was performed for these difficult-to-image patients for England and Wales...
September 20, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Louis Jacob, Karel Kostev
OBJECTIVES: The aim of this study was to analyze prescription patterns and the cost of migraine treatments in general practices (GPs) and neurological practices (NPs) in Germany. METHODS: This study included 43,149 patients treated in GPs and 13,674 patients treated in NPs who were diagnosed with migraine in 2015. Ten different families of migraine therapy were included in the analysis: triptans, analgesics, anti-emetics, beta-blockers, antivertigo products, gastroprokinetics, anti-epileptics, calcium channel blockers, tricyclic antidepressants, and other medications (all other classes used in the treatment of migraine including homeopathic medications)...
September 13, 2016: Pain Practice: the Official Journal of World Institute of Pain
Giuseppe Caminiti, Chiara Fossati, Giuseppe Rosano, Maurizio Volterrani
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
R Talotta, F Atzeni, A Batticciotto, D Ventura, P Sarzi-Puttini
It is still unknown whether there is an association between the use of certolizumab pegol (CZP) in rheumatic patients and the onset of cardiac arrhythmias. We describe the cases of two patients with rheumatoid arthritis (RA) treated with CZP as the first-line biological drug and methotrexate (MTX), who developed an arrhythmic event. The first was a 60-year-old, hypertensive male smoker, the second a 66-year-old dyslipidemic female non-smoker. Both were diagnosed as having RA in 2010, and started treatment with MTX plus CZP...
2016: Reumatismo
Dirk Vollmann, Claudius Hansen
A 35-year-old female was referred with progressive dyspnoea and elevated heart rate. Surface electrocardiography (ECG) showed supraventricular tachycardia (SVT) with long RP interval and inverse P waves. ECG revealed left ventricular dilation and severe systolic dysfunction. An electrophysiological (EP) examination was performed due to incessant SVT despite betablocker medication. Permanent junctional reciprocating tachycardia (PJRT) was diagnosed and successfully ablated. During follow-up, the patient's symptoms abated and ECG parameters normalized...
September 7, 2016: Herzschrittmachertherapie & Elektrophysiologie
Daniel Grinberg, Matteo Pozzi, Fadi Farhat, Jean-François Obadia
The initial aorta (aortic valve, ring, sinuses and ascending aorta) constitutes an inseparable anatomical-functional entity. The "normal" diameter grows with age and body surface area. Two potential risks: aortic regurgitation (chronic complication) and aortic dissection (acute complication) The aortic diameter is the main factor of aortic dissection. Issues of the recommendations: set thresholds to indicate prophylactic surgery (avoid complication) Betablockers are indicated, especially in cases of hypertension or proven familial dystrophy...
September 2, 2016: La Presse Médicale
P Talarowska, A Segiet, M Rozanska, O Mozenska, D A Kosior
OBJECTIVE: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Individuals with OSA are at increased risk of cardiovascular diseases such as arterial hypertension (HTN), heart failure, stroke and pulmonary hypertension. Detailed data regarding hypotensive therapy and its effectiveness in patients with HTN and OSA are lacking. The aim of the study was to characterize in details hypotensive therapy in patients with HTN and OSA. DESIGN AND METHOD: We retrospectively analyzed 1270 patients who were treated in our outpatient sleep apnea clinic...
September 2016: Journal of Hypertension
Anne Nakano, Kenneth Egstrup, Marie Louise Svendsen, Inge Schjødt, Lars Jakobsen, Frank Mehnert, Søren Paaske Johnsen
BACKGROUND: data are sparse on age- and sex-related differences in use of guideline-recommended care and subsequent mortality among patients with heart failure (HF). METHODS: we identified 24,308 incident patients with a verified primary diagnosis of HF recorded during 2003-2010 in the Danish Heart Failure Registry. The registry monitors guideline-recommended processes of care: echocardiography, New York Heart Association Classification, treatment with angiotensin converting enzyme inhibitors/angiotensin II receptor blockers, betablockers, physical training and patient education...
September 2016: Age and Ageing
Eeva Haapio, T Kiviniemi, H Irjala, P Koivunen, J K E Airaksinen, I Kinnunen
Incidence and predictors of peri-operative or post-operative cardiovascular complications in head and neck cancer surgery remain poorly elucidated. In this retrospective study, we investigated the rate and pre-operative risk factors for cardiovascular and cerebrovascular complications. This study included all patients (n = 456) operated for head and neck cancer between 1999 and 2008. Patients' medical records were reviewed and the adjudication of endpoints was performed by adjudication committee. The 30-day incidence of cardiovascular and cerebrovascular complications was 7...
July 4, 2016: European Archives of Oto-rhino-laryngology
Sadeer G Al-Kindi, Chantal ElAmm, Mahazarin Ginwalla, Emile Mehanna, Michael Zacharias, Rodolfo Benatti, Guilherme H Oliveira, Chris T Longenecker
BACKGROUND: Persons living with HIV are at a higher risk of cardiovascular disease despite effective antiretroviral therapy and dramatic reductions in AIDS-related conditions. We sought to identify the epidemiology of heart failure (HF) among persons living with HIV in the United States in an era of contemporary antiretroviral therapy. METHODS: Explorys is an electronic healthcare database that aggregates medical records from 23 healthcare systems nationwide. Using systemized nomenclature of medicine-clinical terms (SNOMED-CT), we identified adult patients (age>18), who had active records over the past year (September 2014-September 2015)...
September 1, 2016: International Journal of Cardiology
Luciana R Remonti, Sofia Dias, Cristiane B Leitão, Caroline K Kramer, Lucas P Klassman, Nicky J Welton, A E Ades, Jorge L Gross
AIMS: The aim of this study was to evaluate the effects of antihypertensive drug classes in mortality in patients with type 2 diabetes. METHODS: MEDLINE, EMBASE, Clinical Trials and Cochrane Library were searched for randomized trials comparing thiazides, beta-blockers, calcium channel blockers (CCBs), angiotensin-converting inhibitors (ACEi) and angiotensin-receptor blockers (ARBs), alone or in combination for hypertension treatment in patients with type 2 diabetes...
August 2016: Journal of Diabetes and its Complications
Luiz Carlos Passos, Márcio Galvão Oliveira, Andre Rodrigues Duraes, Thiago Moreira Trindade, Andréa Cristina Costa Barbosa
Background Beta-blockers have been recommended for patients with heart failure and reduced ejection fraction for their long-term benefits. However, the tolerance to betablockers in patients hospitalized with acute heart failure should be evaluated. Objective To estimate the proportion of patients hospitalized with acute heart failure who can tolerate these agents in clinical practice and compare the clinical outcomes of patients who can and cannot tolerate treatment with beta-blockers. Setting Two reference hospitals in cardiology...
August 2016: International Journal of Clinical Pharmacy
Francesco Santoro, Riccardo Ieva, Armando Ferraretti, Mario Fanelli, Francesco Musaico, Nicola Tarantino, Luigi Di Martino, Luisa De Gennaro, Pasquale Caldarola, Matteo Di Biase, Natale Daniele Brunetti
No abstract text is available yet for this article.
August 2016: Cardiovascular Therapeutics
Francesco Santoro, Riccardo Ieva, Armando Ferraretti, Mario Fanelli, Francesco Musaico, Nicola Tarantino, Luigi Di Martino, Luisa De Gennaro, Pasquale Caldarola, Matteo Di Biase, Natale Daniele Brunetti
BACKGROUND: Left ventricular outflow tract obstruction (LVOTO) may complicate an episode of Takotsubo cardiomyopathy (TTC), potentially leading to cardiogenic shock. Beta-blockers are considered the most suitable treatment for such complication. AIM OF THE STUDY: The objective of this study was to evaluate the hemodynamic effects, safety, and feasibility of a selective beta-blocker (β1) with a short half-life, esmolol, in subjects with a TTC episode. METHODS: Ninety-six consecutive patients with TTC were enrolled in a multicenter registry...
June 2016: Cardiovascular Therapeutics
Jonel Trebicka, Matthias von Heydebrand, Jennifer Lehmann, Flemming Tofteng, Troels Busk, Helle Lone Jensen, Johan Rohde, Thomas Reiberger, Christian Mortensen, Robert Schierwagen, Sabine Klein, Søren Møller, Flemming Bendtsen, Aleksander Krag
BACKGROUND & AIMS: Non-selective beta-blockers (NSBB) are first choice for prevention of variceal bleeding. But possible deleterious effects in refractory ascites and frequent non-response are clinical drawbacks. Since levels of vasoactive proteins in antrum mucosa reflect vascular dysfunction in cirrhosis, these expression levels might also reflect hemodynamic response to NSBB. METHODS: Biopsies from the gastric and duodenal mucosa of 25 patients with cirrhosis were collected and the hepatic venous pressure gradient (HVPG) was measured before and after an acute propranolol challenge...
June 2016: Journal of Hepatology
Adela Alba-Leonel, Alfonso Carvajal, Immaculada Fierro, Fernando Castillo-Nájera, Oscar Campos-Ramos, Antonio Villa-Romero, Juan Molina-Guarneros
Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico...
June 2016: Fundamental & Clinical Pharmacology
Jaromír Hradec
Incidence of chronic heart failure (HF) is increasing steadily in all developed countries, predominantly due to population ageing. The prevalence of HF in population is 1-2%, reaching up to 10% in higher age categories. At present HF is classified according to left ventricular ejection fraction (EF) value to HF with reduced EF (formerly systolic HF) and HF with preserved EF (formerly diastolic HF). Coronary artery disease dominates in the aetiology of HF with reduced EF (about 70%), especially status post myocardial infarction...
2015: Casopís Lékar̆ů C̆eských
José Haba-Rubio, Helena Marti-Soler, Pedro Marques-Vidal, Nadia Tobback, Daniela Andries, Martin Preisig, Gérard Waeber, Peter Vollenweider, Zoltán Kutalik, Mehdi Tafti, Raphaël Heinzer
OBJECTIVE: Periodic limb movements during sleep (PLMS) are sleep phenomena characterized by periodic episodes of repetitive stereotyped limb movements. The aim of this study was to describe the prevalence and determinants of PLMS in a middle to older aged general population. METHODS: Data from 2,162 subjects (51.2% women, mean age = 58.4 ± 11.1 years) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Assessments included laboratory tests, sociodemographic data, personal and treatment history, and full polysomnography at home...
March 2016: Annals of Neurology
Hanna Lenhoff, Börje Darpö, Georg Ferber, Mårten Rosenqvist, Mats Frick
BACKGROUND: Sotalol is recommended to prevent relapse of atrial fibrillation after cardioversion (CV). Sotalol prolongs the action potential by blocking the rapid component of the delayed rectifier potassium current, which results in corrected QT (QTc) prolongation on the electrocardiogram. Pronounced QTc prolongation may lead to proarrhythmias and sudden death. OBJECTIVE: We investigated the dynamics of the QTc interval during the week after CV in patients treated with sotalol compared with patients treated with a β-blocker...
March 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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