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https://www.readbyqxmd.com/read/28944178/alcohol-septal-ablation-in-which-patients-and-why
#1
Paolo Spirito, Jessica Rossi, Barry J Maron
At present, surgical septal myectomy is regarded as the "gold standard" treatment for most patients with obstructive hypertrophic cardiomyopathy (HCM) and drug-refractory symptoms. However, the best results are obtained by those surgeons who have extensive experience with this operation at a small number of referral centers. In the mid-1990s, percutaneous alcohol septal ablation was introduced as an alternative to myectomy to reduce LV outflow gradient and heart failure symptoms in patients with obstructive HCM...
July 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28939710/hemodynamic-profile-of-patients-with-heart-failure-and-preserved-ejection-fraction-vary-by-age
#2
Shane Nanayakkara, Mark Haykowsky, Justin Mariani, Vanessa Van Empel, Micha T Maeder, Donna Vizi, David M Kaye
BACKGROUND: Patients with heart failure with preserved ejection fraction (HFpEF) exhibit a range of cardiovascular phenotypic profiles modified by several common comorbidities. In particular, patients with HFpEF tend to be older; however, it is unclear whether the effects of cardiovascular aging per se modify the expression of HFpEF. We therefore sought to investigate the interaction between age and physiologic profile in patients with HFpEF. METHODS AND RESULTS: We assessed the hemodynamic and metabolic profile of 40 patients with HFpEF...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939708/the-decisions-interventions-and-goals-in-implantable-cardioverter-defibrillator-therapy-dignity-pilot-study
#3
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939460/pharmacotherapy-use-in-older-patients-with-heart-failure-and-reduced-ejection-fraction-after-a-skilled-nursing-facility-stay
#4
Lin Li, Bill M Jesdale, Anne Hume, Giovanni Gambassi, Robert J Goldberg, Kate L Lapane
BACKGROUND: Little is known about guideline-directed pharmacotherapy use in patients with heart failure and reduced ejection fraction (HFrEF) discharged to skilled nursing facilities (SNFs). This study aimed to describe the use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and evidence-based β-blocker (EBBB) among older patients with HFrEF within 90 days after the SNF admission and to identify factors associated with receipt of these medications...
September 19, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28934312/clinical-characteristics-and-12-month-outcomes-of-patients-with-valvular-and-non-valvular-atrial-fibrillation-in-kenya
#5
Tecla M Temu, Kathleen A Lane, Changyu Shen, Loise Ng'ang'a, Constantine O Akwanalo, Peng-Sheng Chen, Wilfred Emonyi, Susan R Heckbert, Myra M Koech, Imran Manji, Matteo Vatta, Eric J Velazquez, Jennifer Wessel, Sylvester Kimaiyo, Thomas S Inui, Gerald S Bloomfield
BACKGROUND: Atrial fibrillation (AF) is a major contributor to the global cardiovascular disease burden. The clinical profile and outcomes of AF patients with valvular heart diseases in sub-Saharan Africa (SSA) have not been adequately described. We assessed clinical features and 12-month outcomes of patients with valvular AF (vAF) in comparison to AF patients without valvular heart disease (nvAF) in western Kenya. METHODS: We performed a cohort study with retrospective data gathering to characterize risk factors and prospective data collection to characterize their hospitalization, stroke and mortality rates...
2017: PloS One
https://www.readbyqxmd.com/read/28932397/undiagnosed-and-diagnosed-diabetes-mellitus-among-hospitalised-acute-heart-failure-patients-in-botswana
#6
Julius Chacha Mwita, Mgaywa Gilbert Mjungu Damas Magafu, Bernard Omech, Billy Tsima, Matthew J Dewhurst, Monkgogi Goepamang, Yohana Mashalla
OBJECTIVE: The objective of this study was to determine the burden of diagnosed and undiagnosed type 2 diabetes mellitus among patients hospitalised with acute heart failure in Botswana. METHODS: The study enrolled 193 consecutive patients admitted with acute heart failure to the medical wards at Princess Marina Hospital in Gaborone. Patients were classified as previously known diabetics, undiagnosed diabetics (glycated haemoglobin ≥ 6.5%) or as non-diabetics (glycated haemoglobin < 6...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28930784/self-care-moderates-the-relationship-between-symptoms-and-health-related-quality-of-life-in-heart-failure
#7
Jonathan P Auld, James O Mudd, Jill M Gelow, Shirin O Hiatt, Christopher S Lee
BACKGROUND: Physical symptoms and depression in heart failure (HF) are key drivers of health-related quality of life (HRQOL). Heart failure self-care behaviors are believed to influence how symptoms affect HRQOL. OBJECTIVE: The goal of this study was to determine if HF self-care behaviors moderate the relationships between physical and depressive symptoms and HRQOL. METHODS: In a cohort of adults with moderate to advanced HF, multivariate linear regression was used to evaluate the interaction between self-care behaviors (Self-care of HF index maintenance and management scales) and physical HF symptoms (HF Somatic Perception Scale) on emotional HRQOL (emotional dimension of Minnesota Living With HF Questionnaire)...
September 20, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28928175/integrated-management-of-atrial-fibrillation-including-tailoring-of-anticoagulation-in-primary-care-study-design-of-the-all-in-cluster-randomised-trial
#8
Carline J van den Dries, Ruud Oudega, Arif Elvan, Frans H Rutten, Sjef J C M van de Leur, Henk J G Bilo, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing
INTRODUCTION: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. However, primary care has not yet played a dominant role in AF management, which has been in fact more fragmented between different healthcare providers...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28927294/treatment-of-patients-with-myocardial-infarction-depends-on-history-of-cancer
#9
Sabine Rohrmann, Fabienne Witassek, Paul Erne, Hans Rickli, Dragana Radovanovic
BACKGROUND: Although cancer treatment considerably affects cardiovascular health, little is known about how cancer patients are treated for an acute myocardial infarction. We aimed to investigate whether acute myocardial infarction patients with a history of cancer received the same guideline recommended treatment as those acute myocardial infarction patients without and whether they differ with respect to inhospital outcome. METHODS: All patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction, enrolled between 2002 and mid-2015 in the acute myocardial infarction in Switzerland (AMIS Plus) registry with comorbidity data based on the Charlson comorbidity index were analysed...
September 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28926002/polygenic-loading-for-major-depression-is-associated-with-specific-medical-comorbidity
#10
T H McCoy, V M Castro, L Snapper, K Hart, J L Januzzi, J C Huffman, R H Perlis
Major depressive disorder frequently co-occurs with medical disorders, raising the possibility of shared genetic liability. Recent identification of 15 novel genetic loci associated with depression allows direct investigation of this question. In cohorts of individuals participating in biobanks at two academic medical centers, we calculated polygenic loading for risk loci reported to be associated with depression. We then examined the association between such loading and 50 groups of clinical diagnoses, or topics, drawn from these patients' electronic health records, determined using a novel application of latent Dirichilet allocation...
September 19, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#11
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28923792/p2y2-nucleotide-receptor-prompts-human-cardiac-progenitor-cell-activation-by-modulating-hippo-signaling
#12
Farid G Khalafalla, Steven R Greene, Hashim Khan, Kelli Ilves, Megan M Monsanto, Roberto Alvarez, Monica Chavarria, Jonathan H Nguyen, Benjamin Norman, Walter P Dembitsky, Mark A Sussman
Rationale: Autologous stem cell therapy using human c-Kit(+) cardiac progenitor cells (hCPCs) is a promising therapeutic approach for treatment of heart failure (HF). However, hCPCs derived from aged HF patients with genetic predispositions and/or comorbidities of chronic diseases exhibit poor proliferative and migratory capabilities, which impairs overall reparative potential for injured myocardium. Therefore, empowering functionally compromised hCPCs with pro-regenerative molecules ex vivo is crucial for improving the therapeutic outcome in HF patients...
September 18, 2017: Circulation Research
https://www.readbyqxmd.com/read/28917516/impact-of-frailty-on-outcomes-in-patients%C3%A2-undergoing-percutaneous-mitral%C3%A2-valve-repair
#13
Clemens Metze, Anna-Sophie Matzik, Maximilian Scherner, Maria Isabel Körber, Guido Michels, Stephan Baldus, Volker Rudolph, Roman Pfister
OBJECTIVES: The aim of this study was to describe the impact of frailty in patients undergoing percutaneous mitral valve repair (PMVR). BACKGROUND: Frailty is common in elderly patients and those with comorbidities and is associated with adverse prognosis. METHODS: Frailty according to the Fried criteria was assessed in consecutive patients admitted for PMVR. Associations of frailty with 6-week (device success, changes in 6-minute walking distance and Minnesota Living With Heart Failure Questionnaire and Short Form 36 physical and mental component scores, and improvement ≥1 New York Heart Association functional class) and long-term outcomes during a median follow-up period of 429 days were examined...
September 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28917022/epidemiology-pathogenesis-and-management-of-takotsubo-syndrome
#14
REVIEW
Shams Y-Hassan, Per Tornvall
Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Patients with predisposing factors such as malignancy and other chronic comorbidities are more prone to suffer from takotsubo syndrome...
September 15, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28916510/outcomes-of-telemedicine-video-conferencing-clinic-versus-in-person-clinic-follow-up-for-implantable-cardioverter-defibrillator-recipients
#15
Khidir Dalouk, Nainesh Gandhi, Peter Jessel, Karen MacMurdy, Ignatius Gerardo Zarraga, Michael Lasarev, Merritt Raitt
BACKGROUND: Implantable cardioverter-defibrillator (ICD) recipients require close follow-up that can be difficult for patients who have to travel long distances for clinic follow-up. We aimed to compare clinical outcomes between ICD patients followed-up in a telemedicine video-conferencing clinic (TMVC) and a conventional in-person clinic (CIC). We hypothesized that outcomes of patients followed in the TMVC are noninferior to the CIC. METHODS AND RESULTS: This retrospective study compares time to first appropriate ICD therapy, time to first inappropriate ICD therapy, time to first shock, and overall survival in patients followed in TMVC compared with CIC between 2001 and 2016...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#16
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28915531/subclinical-hyperthyroidism-and-the-cardiovascular-disease
#17
Alessandro P Delitala
Thyroid hormone excess has complex metabolic effects, particularly on the cardiovascular system. Treatment of these conditions is universally suggested by international guidelines. Subclinical hyperthyroidism, defined by reduced or suppressed TSH levels in the presence of normal free thyroxine and free triiodothyronine values, is common in the general population and progressively increases with aging, being as high as 15.4% in subjects more than 75 years old and more frequent in subjects with nodular goiter...
September 15, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28915393/the-comparative-effectiveness-of-noninvasive-and-invasive-ventilation-in-patients-with-pneumonia
#18
Mihaela S Stefan, Aruna Priya, Penelope S Pekow, Tara Lagu, Jay S Steingrub, Nicholas S Hill, Brian H Nathanson, Peter K Lindenauer
PURPOSE: To compare the outcomes of patients hospitalized with pneumonia treated with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV). MATERIALS AND METHODS: Using the HealthFacts multihospital electronic medical record database, we included patients hospitalized with a diagnosis of pneumonia and treated with NIV or IMV. We developed a propensity model for receipt of initial NIV and assessed the outcomes in a propensity-matched cohort, and in a covariate adjusted and propensity score weighted models...
May 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28904267/trends-in-hospitalizations-for-cardiac-sarcoidosis-in-the-united-states-2005-2011
#19
Xiaofan Guo, Eric Vittinghoff, Vasanth Vedantham, Mark J Pletcher, Byron K Lee
BACKGROUND: Cardiac sarcoidosis (CS) is a life-threatening disease that is frequently under-diagnosed.Methods and Results:We used a nationwide inpatient sample to identify CS patients from 2005 to 2011 in the USA. The annual admissions of CS increased from 1,108 in 2005 to 2,182 in 2011, representing a 2-fold rise over a short time. The proportions of CS patients with severe comorbidities, ventricular tachycardia, ventricular fibrillation and heart failure all increased from 2005 to 2011...
September 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28899350/epidemiological-profile-and-obstetric-outcomes-of-patients-with-peripartum-congestive-heart-failure-in-taiwan-a-retrospective-nationwide-study
#20
Ying-Jen Chang, Chung-Han Ho, Jen-Yin Chen, Ming-Ping Wu, Chia-Hung Yu, Jhi-Joung Wang, Chia-Ming Chen, Chin-Chen Chu
BACKGROUND: During pregnancy, the hyperdynamic physiology of circulation can exacerbate many cardiovascular disorders. Congestive heart failure (CHF) usually occurs during late pregnancy, which is significantly associated with a high level of maternal and neonatal morbidities and mortalities. The profile of women who develop peripartum CHF (PCHF) is unknown. We investigated the epidemiological profiles of PCHF. METHODS: In this retrospective cohort study, PCHF patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in Taiwan's National Health Insurance Research Database...
September 12, 2017: BMC Pregnancy and Childbirth
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