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Yasuyuki Kakihana, Takashi Ito, Mayumi Nakahara, Keiji Yamaguchi, Tomotsugu Yasuda
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis...
2016: Journal of Intensive Care
Martin Reindl, Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Christina Tiller, Agnes Mayr, Gert Klug, Bernhard Metzler
BACKGROUND: Discharge heart rate (HR) following ST-elevation myocardial infarction (STEMI) is a predictor of adverse left ventricular remodelling (LVR). However, the prognostic relevance of HR values in the earlier phase after revascularization is unknown. We aimed to investigate resting HR assessed at different time points during hospital stay following STEMI for the prediction of LVR. METHODS: In this prospective observational study of 143 consecutive STEMI patients, HR was measured serially on admission (AHR), at day 1 (HRd1) and 2 (HRd2) following revascularization and finally at discharge (DHR)...
September 15, 2016: International Journal of Cardiology
Melvin D Lobo, Paul A Sobotka, Atul Pathak
Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious...
July 11, 2016: European Heart Journal
Serenella Castelvecchio, Lorenzo Menicanti, Andrea Garatti, Roberto Tramarin, Marianna Volpe, Alessandro Parolari
Patients affected by diabetes usually have extensive coronary artery disease. Coronary revascularization has a prominent role in the treatment of coronary artery disease in the expanding diabetic population. However, diabetic patients undergoing coronary artery bypass grafting or percutaneous coronary intervention experience worse outcomes than nondiabetic patients. Several studies comparing coronary artery bypass grafting vs percutaneous coronary intervention in subgroups of diabetic patients demonstrated a survival advantage and fewer repeat revascularization procedures with an initial surgical strategy...
September 2016: Annals of Thoracic Surgery
Markku S Nieminen, Michael Buerke, Alain Cohen-Solál, Susana Costa, István Édes, Alexey Erlikh, Fatima Franco, Charles Gibson, Vojka Gorjup, Fabio Guarracino, Finn Gustafsson, Veli-Pekka Harjola, Trygve Husebye, Kristjan Karason, Igor Katsytadze, Sundeep Kaul, Matti Kivikko, Giancarlo Marenzi, Josep Masip, Simon Matskeplishvili, Alexandre Mebazaa, Jacob E Møller, Jadwiga Nessler, Bohdan Nessler, Argyrios Ntalianis, Fabrizio Oliva, Emel Pichler-Cetin, Pentti Põder, Alejandro Recio-Mayoral, Steffen Rex, Richard Rokyta, Ruth H Strasser, Endre Zima, Piero Pollesello
Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease...
September 1, 2016: International Journal of Cardiology
Pardeep S Jhund, John J V McMurray
Inhibition of neurohumoural pathways such as the renin angiotensin aldosterone and sympathetic nervous systems is central to the understanding and treatment of heart failure (HF). Conversely, until recently, potentially beneficial augmentation of neurohumoural systems such as the natriuretic peptides has had limited therapeutic success. Administration of synthetic natriuretic peptides has not improved outcomes in acute HF but modulation of the natriuretic system through inhibition of the enzyme that degrades natriuretic (and other vasoactive) peptides, neprilysin, has proven to be successful...
September 1, 2016: Heart: Official Journal of the British Cardiac Society
Piotr Ponikowski, Adriaan A Voors, Stefan D Anker, Héctor Bueno, John G F Cleland, Andrew J S Coats, Volkmar Falk, José Ramón González-Juanatey, Veli-Pekka Harjola, Ewa A Jankowska, Mariell Jessup, Cecilia Linde, Petros Nihoyannopoulos, John T Parissis, Burkert Pieske, Jillian P Riley, Giuseppe M C Rosano, Luis M Ruilope, Frank Ruschitzka, Frans H Rutten, Peter van der Meer
No abstract text is available yet for this article.
August 2016: European Journal of Heart Failure
João Pedro Ferreira, Nicolas Girerd, Saleh Alshalash, Marvin A Konstam, Faiez Zannad
Atrial fibrillation (AF) and heart failure (HF) often coexist, and patients with AF and HF have a higher risk of thromboembolic events and overall mortality compared with those with AF without HF. Additionally, the prevalence of AF increases with the severity of HF. The use of vitamin K antagonists is more unstable in patients with concomitant AF and HF, which is an independent risk factor for reduced time under therapeutic range. More recently, non-vitamin K antagonists oral anticoagulants (NOACs) have emerged as therapeutic alternatives for stroke prevention in patients with non-valvular AF, as they have been shown to be at least as efficacious and safe, with less intracranial bleeding events, compared with vitamin K antagonists...
August 2016: European Heart Journal
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Sophie Wallace
BACKGROUND: Most patients with coronary artery disease receive aspirin for primary or secondary prevention of myocardial infarction, stroke, and death. Aspirin poses a risk of bleeding in patients undergoing surgery, but it is unclear whether aspirin should be stopped before coronary artery surgery. METHODS: We used a 2-by-2 factorial trial design to randomly assign patients who were scheduled to undergo coronary artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo...
February 25, 2016: New England Journal of Medicine
Line Melgaard, Anders Gorst-Rasmussen, Deidre A Lane, Lars Hvilsted Rasmussen, Torben Bjerregaard Larsen, Gregory Y H Lip
IMPORTANCE: The CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years [doubled], diabetes, stroke/transient ischemic attack/thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) is used clinically for stroke risk stratification in atrial fibrillation (AF). Its usefulness in a population of patients with heart failure (HF) is unclear. OBJECTIVE: To investigate whether CHA2DS2-VASc predicts ischemic stroke, thromboembolism, and death in a cohort of patients with HF with and without AF...
September 8, 2015: JAMA: the Journal of the American Medical Association
Aram V Chobanian
No abstract text is available yet for this article.
June 28, 2016: JAMA: the Journal of the American Medical Association
Adam K McDiarmid, Pierpaolo Pellicori, John G Cleland, Sven Plein
The terms used to describe different states of myocardial health and disease are poorly defined. Imprecision and inconsistency in nomenclature can lead to difficulty in interpreting and applying trial outcomes to clinical practice. In particular, the terms 'viable' and 'hibernating' are commonly applied interchangeably and incorrectly to myocardium that exhibits chronic contractile dysfunction in patients with ischaemic heart disease. The range of inherent differences amongst imaging modalities used to define myocardial health and disease add further challenges to consistent definitions...
May 4, 2016: European Heart Journal
John L Sapp, George A Wells, Ratika Parkash, William G Stevenson, Louis Blier, Jean-Francois Sarrazin, Bernard Thibault, Lena Rivard, Lorne Gula, Peter Leong-Sit, Vidal Essebag, Pablo B Nery, Stanley K Tung, Jean-Marc Raymond, Laurence D Sterns, George D Veenhuyzen, Jeff S Healey, Damian Redfearn, Jean-Francois Roux, Anthony S L Tang
BACKGROUND: Recurrent ventricular tachycardia among survivors of myocardial infarction with an implantable cardioverter-defibrillator (ICD) is frequent despite antiarrhythmic drug therapy. The most effective approach to management of this problem is uncertain. METHODS: We conducted a multicenter, randomized, controlled trial involving patients with ischemic cardiomyopathy and an ICD who had ventricular tachycardia despite the use of antiarrhythmic drugs. Patients were randomly assigned to receive either catheter ablation (ablation group) with continuation of baseline antiarrhythmic medications or escalated antiarrhythmic drug therapy (escalated-therapy group)...
July 14, 2016: New England Journal of Medicine
Z I Chen, D I Ai
Compared with traditional chemotherapy, targeted cancer therapy is a novel strategy in which key molecules in signaling pathways involved in carcinogenesis and tumor spread are inhibited. Targeted cancer therapy has fewer adverse effects on normal cells and is considered to be the future of chemotherapy. However, targeted cancer therapy-induced cardiovascular toxicities are occasionally critical issues in patients who receive novel anticancer agents, such as trastuzumab, bevacizumab, sunitinib and imatinib...
May 2016: Molecular and Clinical Oncology
James E Udelson, Camille A Pearte, Carey D Kimmelstiel, Mariusz Kruk, Joseph A Kufera, Sandra A Forman, Anna Teresinska, Bartosz Bychowiec, Jose Antonio Marin-Neto, Thomas Höchtl, Eric A Cohen, Paulo Caramori, Benita Busz-Papiez, Christopher Adlbrecht, Zygmunt P Sadowski, Witold Ruzyllo, Debra J Kinan, Gervasio A Lamas, Judith S Hochman
BACKGROUND: The Occluded Artery Trial (OAT) showed no difference in outcomes between percutaneous coronary intervention (PCI) versus optimal medical therapy (MED) in patients with persistent total occlusion of the infarct-related artery 3 to 28 days post-myocardial infarction. Whether PCI may benefit a subset of patients with preservation of infarct zone (IZ) viability is unknown. METHODS AND RESULTS: The OAT nuclear ancillary study hypothesized that (1) IZ viability influences left ventricular (LV) remodeling and that (2) PCI as compared with MED attenuates adverse remodeling in post-myocardial infarction patients with preserved viability...
March 2011: American Heart Journal
Michel T Corban, Olivia Y Hung, Parham Eshtehardi, Emad Rasoul-Arzrumly, Michael McDaniel, Girum Mekonnen, Lucas H Timmins, Jerre Lutz, Robert A Guyton, Habib Samady
Patients with myocardial bridging are often asymptomatic, but this anomaly may be associated with exertional angina, acute coronary syndromes, cardiac arrhythmias, syncope, or even sudden cardiac death. This review presents our understanding of the pathophysiology of myocardial bridging and describes prevailing diagnostic modalities and therapeutic options for this challenging clinical entity.
June 10, 2014: Journal of the American College of Cardiology
Arman Qamar, Deepak L Bhatt
No abstract text is available yet for this article.
April 12, 2016: Circulation
Akshay S Desai, Pardeep S Jhund
Although patients with heart failure and preserved ejection fraction (HF-PEF) represent nearly half of the population with chronic heart failure, few evidence-based medical therapies are available. The neutral overall results of the TOPCAT trial of spironolactone in HF-PEF leave clinicians who treat heart failure with an ongoing clinical dilemma. In this review, we outline an approach to the clinical management of the patient with HF-PEF synthesizing data from available clinical trials and expert consensus.
April 13, 2016: European Heart Journal
Kristen K Patton, Patrick T Ellinor, Michael Ezekowitz, Peter Kowey, Steven A Lubitz, Marco Perez, Jonathan Piccini, Mintu Turakhia, Paul Wang, Sami Viskin
No abstract text is available yet for this article.
April 12, 2016: Circulation
Jackson T Wright, Jeff D Williamson, Paul K Whelton, Joni K Snyder, Kaycee M Sink, Michael V Rocco, David M Reboussin, Mahboob Rahman, Suzanne Oparil, Cora E Lewis, Paul L Kimmel, Karen C Johnson, David C Goff, Lawrence J Fine, Jeffrey A Cutler, William C Cushman, Alfred K Cheung, Walter T Ambrosius
BACKGROUND: The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain. METHODS: We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes...
November 26, 2015: New England Journal of Medicine
2016-04-15 12:44:34
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