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https://www.readbyqxmd.com/read/29684994/postoperative-infusion-of-a-low-dose-of-dexmedetomidine-reduces-intravenous-consumption-of-sufentanil-in-patient-controlled-analgesia
#1
Dae-Eun Kweon, Youngbin Koo, Seonyi Lee, Kumhee Chung, Sowoon Ahn, Chunghyun Park
Background: Combining adjunctive medications with patient-controlled analgesia (PCA) has been used to minimize opioid related side-effects. The aim of this study was to evaluate whether postoperative infusion of a sub-sedative dose of dexmedetomidine can reduce opioid consumption and opioid related side-effects. Methods: We selected 60 patients from 18 to 60 years old with an American Society of Anesthesiologists physical status of 1-2 who were scheduled for elective surgery...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29681957/mechanical-circulatory-support-is-effective-to-treat-pulmonary-hypertension-in-heart-transplant-candidates-disqualified-due-to-unacceptable-pulmonary-vascular-resistance
#2
Michał Zakliczyński, Jerzy Pacholewicz, Izabela Copik, Marcin Maruszewski, Tomasz Hrapkowicz, Roman Przybylski, Marian Zembala
Introduction: High pulmonary vascular resistance (PVR) in orthotopic heart transplantation (OHT) candidates is a risk factor of right ventricle failure after the procedure. However, the increase of PVR may be a consequence of the life-threatening deterioration of the left ventricle function. The use of mechanical circulatory support (MCS) seems to be the best solution, but it is reimbursed only in active OHT candidates. Aim: We performed a retrospective analysis of MCS effectiveness in maintaining PVR at values accepted for OHT...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29677073/outcomes-after-cardiac-transplant-for-wild-type-transthyretin-amyloidosis
#3
Andrew N Rosenbaum, Omar F Abou Ezzeddine, Martha Grogan, Angela Dispenzieri, Sudhir Kushwaha, Alfredo Clavell, Richard C Daly, Brooks S Edwards
BACKGROUND: The true prevalence of heart failure (HF) due to wild type transthyretin amyloidosis (ATTRwt) is likely underestimated. There is a paucity of data with regard to the management of ATTRwt-related advanced HF and the natural history of extracardiac ATTRwt. METHODS: We conducted a retrospective cohort study of patients undergoing cardiac transplant (HTx) for ATTRwt at a single institution. Comprehensive clinical data, including baseline hemodynamic and echocardiographic characteristics, and posttransplant outcomes were obtained...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29673507/pre-angioplasty-instantaneous-wave-free-ratio-pullback-predicts-hemodynamic-outcome-in-humans-with-coronary-artery-disease-primary-results-of-the-international-multicenter-ifr-gradient-registry
#4
Yuetsu Kikuta, Christopher M Cook, Andrew S P Sharp, Pablo Salinas, Yoshiaki Kawase, Yasutsugu Shiono, Alessandra Giavarini, Masafumi Nakayama, Salvatore De Rosa, Sayan Sen, Sukhjinder S Nijjer, Rasha Al-Lamee, Ricardo Petraco, Iqbal S Malik, Ghada W Mikhail, Raffi R Kaprielian, Gilbert W M Wijntjens, Shinsuke Mori, Arata Hagikura, Martin Mates, Atsushi Mizuno, Farrel Hellig, Kelvin Lee, Luc Janssens, Kazunori Horie, Shah Mohdnazri, Raul Herrera, Florian Krackhardt, Masahiro Yamawaki, John Davies, Hideo Takebayashi, Thomas Keeble, Seiichi Haruta, Flavio Ribichini, Ciro Indolfi, Jamil Mayet, Darrel P Francis, Jan J Piek, Carlo Di Mario, Javier Escaned, Hitoshi Matsuo, Justin E Davies
OBJECTIVES: The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings. BACKGROUND: In tandem and diffuse disease, offline analysis of continuous iFR pullback measurement has previously been demonstrated to accurately predict the physiological outcome of revascularization...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29671040/preoperative-right-heart-hemodynamics-predict-postoperative-acute-kidney-injury-after-heart-transplantation
#5
Goksel Guven, Milos Brankovic, Alina A Constantinescu, Jasper J Brugts, Dennis A Hesselink, Sakir Akin, Ard Struijs, Ozcan Birim, Can Ince, Olivier C Manintveld, Kadir Caliskan
PURPOSE: Acute kidney injury (AKI) frequently occurs after heart transplantation (HTx), but its relation to preoperative right heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. METHODS: From 1984 to 2016, all consecutive HTx recipients (n = 595) in our tertiary referral center were included and analyzed for the occurrence of postoperative AKI staged by the kidney disease improving global outcome criteria...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29664407/mechanical-circulatory-support-device-utilization-and-heart-transplant-waitlist-outcomes-in-patients-with-restrictive-and-hypertrophic-cardiomyopathy
#6
Lakshmi Sridharan, Brian Wayda, Lauren K Truby, Farhana Latif, Susan Restaino, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, Mathew Maurer, Maryjane A Farr, Veli K Topkara
BACKGROUND: Patients with restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) generally are considered poor candidates for mechanical circulatory support devices (MCSDs) and often not able to be bridged mechanically to heart transplantation. This study characterized MCSD utilization and transplant waitlist outcomes in patients with RCM/HCM under the current allocation system and discusses changes in the era of the new donor allocation system. METHODS AND RESULTS: Patients waitlisted from 2006 to 2016 in the United Network for Organ Sharing registry were stratified by RCM/HCM versus other diagnoses...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29657755/landslides-and-dam-damage-resulting-from-the-jiuzhaigou-earthquake-8-august-2017-sichuan-china
#7
Bo Zhao, Yun-Sheng Wang, Yong-Hong Luo, Jia Li, Xin Zhang, Tong Shen
At 21.19 on 8 August 2017, an Ms 7.0 earthquake struck the Jiuzhaigou scenic spot in northwestern Sichuan Province, China. The Jiuzhaigou earthquake is a strike-slip earthquake with a focal depth of 20 km at 33.20° N and 103.82° E, and was caused by two concealed faults. According to emergency investigations and remote sensing interpretations, the Jiuzhaigou earthquake triggered 1780 landslides, damaged one dam (Nuorilang Waterfall) and broke one dam (Huohua Lake). The landslides mainly occurred in the Rize Valley and Shuzheng Valley and in Jiuzhai Paradise...
March 2018: Royal Society Open Science
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#8
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29629733/exercise-hemodynamics-for-the-diagnosis-of-diastolic-dysfunction-in-dyspneic-patients-with-systemic-sclerosis
#9
Anne Graham Cummiskey, Amit Segev, Michael Segel, Jonathan Buber, Victor Guetta, Israel M Barbash, Dan Elian, Elad Asher, Ori Vaturi, Paul Fefer
OBJECTIVES: To assess the added diagnostic value of using exercise hemodynamics during RHC in assessment of patients with symptomatic SSc. METHODS: We performed 22 RHCs in 17 SSc patients with dyspnea and/or pulmonary arterial hypertension (PAH). Exercise was performed in 15 RHCs using isotonic arm exercises while holding a 1 kg weight in each hand. Measurements of pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), and cardiac output (CO) were taken at rest and during peak exercise...
April 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29617005/high-right-ventricular-stroke-work-index-is-associated-with-worse-kidney-function-in-patients-with-heart-failure-with-preserved-ejection-fraction
#10
Napatt Kanjanahattakij, Natee Sirinvaravong, Francisco Aguilar, Akanksha Agrawal, Parasuram Krishnamoorthy, Shuchita Gupta
BACKGROUND: In patients with heart failure with preserved ejection fraction (HFpEF), worse kidney function is associated with worse overall cardiac mechanics. Right ventricular stroke work index (RVSWI) is a parameter of right ventricular function. The aim of our study was to determine the relationship between RVSWI and glomerular filtration rate (GFR) in patients with HFpEF. METHOD: This was a single-center cross-sectional study. HFpEF is defined as patients with documented heart failure with ejection fraction > 50% and pulmonary wedge pressure > 15 mm Hg from right heart catheterization...
February 28, 2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29609885/institution-of-localized-high-frequency-electrical-stimulation-targeting-early-myocardial-infarction-effects-on-left-ventricle-function-and-geometry
#11
Michael C Genau, Paige E Perreault, Eva Romito, Heather Doviak, Christina B Logdon, Stephen Ruble, Francis G Spinale
BACKGROUND: Although strategies have focused on myocardial salvage/regeneration in the context of an acute coronary syndrome and a myocardial infarction (MI), interventions targeting the formed MI region and altering the course of the post-MI remodeling process have not been as well studied. This study tested the hypothesis that localized high-frequency stimulation instituted within a formed MI region using low-amplitude electrical pulses would favorably change the trajectory of changes in left ventricle geometry and function...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29605474/hemodynamic-mechanisms-of-exercise-induced-pulmonary-hypertension-in-patients-with-lymphangioleiomyomatosis-the-role-of-exercise-stress-echocardiography
#12
Andrea Sonaglioni, Massimo Baravelli, Roberto Cassandro, Olga Torre, Davide Elia, Claudio Anzà, Sergio Harari
BACKGROUND: The pathogenesis of pulmonary hypertension (PH) in lymphangioleiomyomatosis (LAM) has not yet been completely clarified. The aim of this study was to conduct a noninvasive evaluation of the main hemodynamic mechanisms of exercise-induced PH in patients with LAM, assessed using exercise stress echocardiography. METHODS: Fifteen patients with LAM (mean age, 47 ± 13 years; all women) without resting PH were enrolled in a prospective single-center study and compared with 15 healthy female control subjects (mean age, 45...
March 28, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29597051/prognostic-impact-of-pulmonary-artery-pulsatility-index-papi-in-patients-with-advanced-heart-failure-insights-from-the-escape-trial
#13
Stephanie Meller Kochav, Raul J Flores, Lauren K Truby, Veli K Topkara
BACKGROUND: The pulmonary artery pulsatility index (PAPi) - defined as the ratio of pulmonary artery pulse pressure to right atrial pressure -emerged as a powerful predictor of right ventricular (RV) failure in patients with acute inferior myocardial infarction and those undergoing left ventricular assist device placement, however, its prognostic utility in the advanced heart failure population remains largely unknown. METHODS AND RESULTS: We comparatively analyzed PAPi with traditional indices of RV function including RV stroke work index (RVSWI) and right atrial /pulmonary capillary wedge pressure ratio (RAP/PCWP) in the ESCAPE trial...
March 26, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29590308/comparing-pulmonary-arterial-wedge-pressure-and-left-ventricular-end-diastolic-pressure-for-assessment-of-left-sided-filling-pressures
#14
Yogesh N V Reddy, Abdallah El-Sabbagh, Rick A Nishimura
No abstract text is available yet for this article.
March 28, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29587875/evaluation-of-a-novel-device-for-the-management-of-high-blood-pressure-and-shock-in-pregnancy-in-low-resource-settings-study-protocol-for-a-stepped-wedge-cluster-randomised-controlled-trial-cradle-3-trial
#15
Hannah L Nathan, Kate Duhig, Nicola Vousden, Elodie Lawley, Paul T Seed, Jane Sandall, Mrutyunjaya B Bellad, Adrian C Brown, Lucy C Chappell, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Andrew H Shennan
BACKGROUND: Obstetric haemorrhage, sepsis and pregnancy hypertension account for more than 50% of maternal deaths worldwide. Early detection and effective management of these conditions relies on vital signs. The Microlife® CRADLE Vital Sign Alert (VSA) is an easy-to-use, accurate device that measures blood pressure and pulse. It incorporates a traffic-light early warning system that alerts all levels of healthcare provider to the need for escalation of care in women with obstetric haemorrhage, sepsis or pregnancy hypertension, thereby aiding early recognition of haemodynamic instability and preventing maternal mortality and morbidity...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29580694/mean-right-atrial-pressure-for-estimation-of-left-ventricular-filling-pressure-in-patients-with-normal-left-ventricular-ejection-fraction-invasive-and-noninvasive-validation
#16
Sherif F Nagueh, Otto A Smiseth, Hisham Dokainish, Oyvind S Andersen, Muaz M Abudiab, Robert C Schutt, Arnav Kumar, Einar Gude, Kimi Sato, Serge C Harb, Allan L Klein
BACKGROUND: There is a paucity of data on the utility of right atrial pressure (RAP) for estimating pulmonary capillary wedge pressure (PCWP) in patients with normal ejection fraction (EF), including patients with heart failure with preserved EF. METHODS: Mean RAP was compared with PCWP in 129 patients (mean age, 61 ± 11 years; 45% men) with exertional dyspnea enrolled in a multicenter study. Measurements included left ventricular volumes, EF, and mitral inflow velocities...
March 23, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29573567/comparison-of-continuous-flow-ventricular-assist-device-therapy-with-intensive-medical-therapy-in-fixed-pulmonary-hypertension-secondary-to-advanced-left-heart-failure
#17
Gayathri Kumarasinghe, Pankaj Jain, Andrew Jabbour, Jacqueline Lai, Anne M Keogh, Eugene Kotlyar, Paul Jansz, Peter S Macdonald, Christopher S Hayward
AIMS: Both ventricular assist device (VAD) and pulmonary vasodilator therapy have been shown in uncontrolled studies to improve pulmonary hypertension secondary to advanced left heart failure (Group 2 PH). This study aimed to compare haemodynamic benefits and survival in patients with fixed Group 2 PH treated with continuous-flow VAD to intensive medical therapy. METHODS AND RESULTS: Ninety-five patients listed for heart transplantation with sequential right heart catheters were studied, 24 patients having fixed Group 2 PH (as defined by cardiac index < 2...
March 24, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29559180/fluid-challenge-predicts-clinical-worsening-in-pulmonary-arterial-hypertension
#18
Michele D'Alto, Yoshiki Motoji, Emanuele Romeo, Paola Argiento, Giovanni Maria Di Marco, Agostino Mattera Iacono, Antonello D'Andrea, Gaetano Rea, Paolo Golino, Robert Naeije
AIM: A fluid challenge with rapid saline infusion during right heart catheterization has been shown to be useful for the differential diagnosis between pre- and post-capillary pulmonary hypertension. The aim of this study was to evaluate the prognostic relevance of fluid challenge-induced changes in pulmonary hemodynamics in patients with pulmonary arterial hypertension (PAH). METHODS: Overall, 118 PAH patients (mean age 57 ± 15 years, 80 female) underwent hemodynamic measurements before and after rapid saline infusion (7 mL/kg in 10 min) and were followed up for 19 ± 4 months...
March 7, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29550313/noninvasive-assessment-of-hemodynamic-status-in-heartware-left-ventricular-assist-device-patients-validation-of-an-echocardiographic-approach
#19
Simone Frea, Paolo Centofanti, Stefano Pidello, Francesca Giordana, Virginia Bovolo, Andrea Baronetto, Beatrice Franco, Marco Matteo Cingolani, Matteo Attisani, Mara Morello, Serena Bergerone, Mauro Rinaldi, Fiorenzo Gaita
OBJECTIVES: The aim of this prospective study was to validate an echocardiographic protocol derived from 5 HeartWare left ventricular assist device (HVAD) patients for the noninvasive evaluation of right atrial pressure (RAP) and left atrial pressure (LAP) in HVAD patients. BACKGROUND: Echocardiography is an invaluable tool to optimize medical treatment and pump settings and also for troubleshooting residual heart failure. Little is known about the echocardiographic evaluation of hemodynamic status in HVAD patients...
March 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29547029/a-two-stage-foot-repair-in-a-55-year-old-man-with-poliomyelitis
#20
Daniel Pollack
A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure...
January 2018: Journal of the American Podiatric Medical Association
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