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https://www.readbyqxmd.com/read/28105999/transcatheter-aortic-valve-replacement-with-the-portico-valve-one-year-results-of-the-early-canadian-experience
#1
Gidon Y Perlman, Anson Cheung, Eric Dumont, Dion Stub, Danny Dvir, Maria Del Trigo, Marc Pelletier, Sami Alnasser, Jian Ye, David Wood, Christopher Thompson, Philipp Blanke, Jonathon Leipsic, Michael A Seidman, Heather LeBlanc, Christopher E Buller, Josep Rodés-Cabau, John G Webb
AIMS: The aim of this study was to examine the short- and medium-term outcomes of transcatheter aortic valve replacement (TAVR) with the self-expanding and repositionable Portico valve (St. Jude Medical, St. Paul, MN, USA). METHODS AND RESULTS: A total of 57 patients underwent TAVR with the Portico valve between March 2012 and August 2014, representing the first-in-human experience and the entire early experience in Canada. Patients were followed up at 30 days and one year with repeat echocardiography and clinical review...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105791/the-future-of-pleiotropic-therapy-in-heart-failure-lessons-from-the-benefits-of-exercise-training-on-endothelial-function
#2
REVIEW
Gilles W De Keulenaer, Vincent F M Segers, Faiez Zannad, Dirk L Brutsaert
A novel generation of drugs is introduced in the treatment of heart failure (HF). These drugs, including phosphodiesterase-5 inhibitors, guanylate cyclase stimulators and activators, share the feature that their action is either endothelial-mediated or substitutes for endothelial pathways, in particular the nitric oxide-cyclic guanosine monophosphate pathway, thereby influencing homeostatic balances in virtually each organ system in a pleiotropic fashion. Unfortunately, recent clinical trials with some of these drugs have shown disappointing results, at least in the setting of HF with a preserved ejection fraction...
January 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#3
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28102878/pulmonary-hypertension-associated-with-left-sided-heart-disease
#4
Micha Tobias Maeder, Otto D Schoch, Rebekka Kleiner, Lucas Joerg, Daniel Weilenmann, Swiss Society For Pulmonary Hypertension
Pulmonary hypertension associated with left-sided heart disease (PH-LHD) is the most common type of pulmonary hypertension. In patients with left-sided heart disease, the presence of pulmonary hypertension is typically a marker of more advanced disease, more severe symptoms, and worse prognosis. In contrast to pulmonary arterial hypertension, PH-LHD is characterised by an elevated pulmonary artery wedge pressure (postcapillary pulmonary hypertension) without or with an additional precapillary component (isolated postcapillary versus combined postcapillary and precapillary pulmonary hypertension)...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28102021/high-prevalence-of-diabetes-and-anthropometric-heterogeneity-among-tuberculosis-patients-in-pakistan
#5
Huma Aftab, Atiqa Ambreen, Mohammad Jamil, Peter Garred, Jørgen H Petersen, Susanne D Nielsen, Ib C Bygbjerg, Dirk L Christensen
BACKGROUND: In Pakistan the prevalence of diabetes (DM) among adults is 6.9% and expected to double by 2040. DM may facilitate transmission and halter the elimination of tuberculosis (TB). We aimed to determine the prevalence of DM among TB patients in Pakistan and to investigate anthropometric biochemical, and haemodynamic associations between TB patients with and without DM. METHODS: We conducted a cross-sectional study at Gulab Devi Chest Hospital in Lahore, Punjab...
January 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28101819/high-central-aortic-rather-than-brachial-blood-pressure-is-associated-with-carotid-wall-remodeling-and-increased-arterial-stiffness-in-childhood
#6
Gonzalo Peluso, Victoria García-Espinosa, Santiago Curcio, Marco Marota, Juan Castro, Pedro Chiesa, Gustavo Giachetto, Daniel Bia, Yanina Zócalo
INTRODUCTION: In adults, central blood pressure (cBP) is reported to associate target organ damages (TODs) rather than peripheral blood pressure (pBP). However, data regarding the association of pre-clinical TODs with cBP and pBP in pediatric populations are scarce. AIM: To evaluate in children and adolescents the importance of cBP and pBP levels, in terms of their association with hemodynamic and vascular changes. METHODS: 315 subjects [age (mean/range) 12/8-18 years] were included...
January 19, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28100569/multiple-pregnancy-in-a-primigravida-with-uncorrected-pentalogy-of-fallot
#7
Pamela Partana, Jarrod Kah Hwee Tan, Ju Le Tan, Lay Kok Tan
Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100521/perioperative-%C3%AE-receptor-blockade-in-phaeochromocytoma-surgery-an-observational-case-series
#8
H Groeben, B J Nottebaum, P F Alesina, A Traut, H P Neumann, M K Walz
BACKGROUND: Mortality associated with surgery for phaeochromocytoma has dramatically decreased over the last decades. Many factors contributed to the dramatic decline of the mortality rate, and the influence of an α-receptor blockade is unclear and has never been tested in a randomized trial. We evaluated intraoperative haemodynamic conditions and the incidence of complications in patients with and without α-receptor blockade undergoing surgery for catecholamine producing tumours. METHODS: Haemodynamic conditions and perioperative complications were assessed in 110 patients with (B) and 166 without (N) α-receptor blockade...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100520/evidence-basis-for-using-perineural-dexmedetomidine-to-enhance-the-quality-of-brachial-plexus-nerve-blocks-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
L Vorobeichik, R Brull, F W Abdallah
BACKGROUND: Dexmedetomidine has been proposed as a perineural local anaesthetic (LA) adjunct to prolong peripheral nerve block duration; however, results from our previous meta-analysis in the setting of brachial plexus block (BPB) did not support its use. Many additional randomized trials have since been published. We thus conducted an updated meta-analysis. METHODS: Randomized trials investigating the addition of dexmedetomidine to LA compared with LA alone (Control) in BPB for upper extremity surgery were sought...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099988/exercise-based-rehabilitation-programmes-for-pulmonary-hypertension
#10
REVIEW
Norman R Morris, Fiona D Kermeen, Anne E Holland
BACKGROUND: Individuals with pulmonary hypertension (PH) have reduced exercise capacity and quality of life. Despite initial concerns that exercise training may worsen symptoms in this group, several studies have reported improvements in functional capacity and well-being following exercise-based rehabilitation in PH. OBJECTIVES: To assess the efficacy and safety of exercise-based rehabilitation for people with PH. Primary outcomes were exercise capacity, adverse events during the intervention period and health-related quality of life (HRQoL)...
January 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28096285/epoprostenol-and-pulmonary-arterial-hypertension-20%C3%A2-years-of-clinical-experience
#11
REVIEW
Olivier Sitbon, Anton Vonk Noordegraaf
Epoprostenol was the first therapy to be approved for the treatment of pulmonary arterial hypertension (PAH). In the 20 years since the introduction of this prostacyclin analogue, the outlook for patients with PAH has improved, with survival rates now double those from the era before the development of disease-specific treatments. Today, there are a large amount of data on the clinical role of prostacyclin treatments and a body of evidence attesting the efficacy of epoprostenol in improving exercise capacity, key haemodynamic parameters and PAH symptoms, as well as in reducing mortality...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28093621/outcome-of-elderly-undergoing-extracorporeal-life-support-in-refractory-cardiogenic-shock
#12
Suzanne de Waha, Tobias Graf, Steffen Desch, Georg Fuernau, Ingo Eitel, Janine Pöss, Alexander Jobs, Thomas Stiermaier, Jakob Ledwoch, Ariane Wiedau, Philipp Lurz, Gerhard Schuler, Holger Thiele
BACKGROUND: The current study presents data from a real-world cohort of patients with refractory cardiogenic shock (CS) undergoing extracorporeal life support (ECLS) focusing on the comparison of elderly versus younger patients. METHODS AND RESULTS: One hundred consecutive patients with refractory CS underwent percutaneous ECLS implantation performed by interventional cardiologists. Follow-up was performed at hospital discharge as well as at a median of 18 months [interquartile range 15-36]...
January 16, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28091707/gastric-distension-causes-changes-in-heart-rate-and-arterial-blood-pressure-by-affecting-the-crosstalk-between-vagal-and-splanchnic-systems-in-anesthetised-rats
#13
Maurizio Sabbatini, Elena Grossini, Claudio Molinari, David A S G Mary, Giovanni Vacca, Mario Cannas
Various hindbrain nuclei have been demonstrated to be involved in the control of the cardiovascular reflexes elicited by both non-noxious and noxious gastric distension, through parasympathetic and sympathetic activation. The different role played by the branches of autonomic nervous system in exerting these effects and their crosstalk in relation to low-/high-pressure distension rate has not been examined yet. Therefore, in the present work, monolateral and bilateral vagotomy and splanchnicotomy were performed in anesthetised rats to analyse the involvement of hindbrain nuclei in haemodynamic changes caused by gastric distension at high (80 mmHg) and low (15 mmHg) pressure...
January 13, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28087362/clinical-phenotypes-and-outcomes-of-heritable-and-sporadic-pulmonary-veno-occlusive-disease-a-population-based-study
#14
David Montani, Barbara Girerd, Xavier Jaïs, Marilyne Levy, David Amar, Laurent Savale, Peter Dorfmüller, Andrei Seferian, Edmund M Lau, Mélanie Eyries, Jérôme Le Pavec, Florence Parent, Damien Bonnet, Florent Soubrier, Elie Fadel, Olivier Sitbon, Gérald Simonneau, Marc Humbert
BACKGROUND: Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS: We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases)...
January 10, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28087158/echocardiographic-approach-to-cardiac-tamponade-in-critically-ill-patients
#15
REVIEW
Peter McCanny, Frances Colreavy
Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. Diagnostic sensitivity of transthoracic echocardiography is dependent on image quality, and in some cases a transoesophageal approach may be required to confirm the diagnosis. Knowledge of the pathophysiology and echocardiographic features of cardiac tamponade are essential for the practicing Intensivist...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28079557/dobutamine-aggravates-haemodynamic-deterioration-induced-by-pleural-effusion-a-randomised-controlled-porcine-study
#16
Kristian B Wemmelund, Anders H Sørensen, Viktor K Ringgård, Erik Sloth, Peter Juhl-Olsen
BACKGROUND: Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. OBJECTIVE: We hypothesised that dobutamine would affect the physiological determinants preload, afterload, contractility and changes of inferior vena cava characteristics during experimental pleural effusion. DESIGN: A randomised, controlled laboratory study. SETTING: Animal laboratory, conducted from March 2013 to May 2013...
January 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#17
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28077762/inverse-problems-in-reduced-order-models-of-cardiovascular-haemodynamics-aspects-of-data-assimilation-and-heart-rate-variability
#18
Sanjay Pant, Chiara Corsini, Catriona Baker, Tain-Yen Hsia, Giancarlo Pennati, Irene E Vignon-Clementel
Inverse problems in cardiovascular modelling have become increasingly important to assess each patient individually. These problems entail estimation of patient-specific model parameters from uncertain measurements acquired in the clinic. In recent years, the method of data assimilation, especially the unscented Kalman filter, has gained popularity to address computational efficiency and uncertainty consideration in such problems. This work highlights and presents solutions to several challenges of this method pertinent to models of cardiovascular haemodynamics...
January 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#19
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077469/risk-factors-for-excess-mortality-in-adults-with-congenital-heart-diseases
#20
Jose Maria Oliver, Pastora Gallego, Ana Elvira Gonzalez, Diego Garcia-Hamilton, Pablo Avila, Raquel Yotti, Ignacio Ferreira, Francisco Fernandez-Aviles
AIMS: To examine factors related to excess mortality in a cohort of adults with congenital heart disease (CHD). METHODS AND RESULTS: We conducted a survival analysis using prospective data of 3311 adults with CHD [50.5% males, median age at entry 22.5 years (IQR 18-39), median follow-up time 10.5 years (IQR: 4.4-18)]. Survival status of each patient was further verified by cross checking with the Spanish National Death Index. During a total follow-up of 37608 person-years, 336 (10%) patients died...
January 10, 2017: European Heart Journal
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