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Heart Failure

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936 papers 100 to 500 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/28699071/microvascular-dysfunction-in-infiltrative-cardiomyopathies
#1
Ornella Rimoldi, Francesco Maranta
Infiltrative heart diseases are characterized by myocardial tissue alterations leading to mechanical dysfunction which in turn develops into bi-ventricular congestive heart failure. Also the coronary microvasculature undergoes significant remodeling and dysfunction. The effects of the unbalance of the mechanical cross-talk between cardiac muscle and vessels and of the impairment of vasodilatory function can be measured non-invasively by means of positron emission tomography and cardiac magnetic resonance.
July 11, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28699408/bridging-the-gap-between-heart-failure-and-the-device-clinic
#2
John Rickard, Bruce L Wilkoff
While cardiac resynchronization therapy (CRT) is a mainstay in the management of selected patients with chronic systolic dysfunction, many patients are noted to experience less than expected or no benefit at all from the therapy. Multidisciplinary care has been shown to provide benefit in follow up for patients receiving CRT devices. Areas Covered: This review will focus on the apparent reasons behind less than optimal outcomes following CRT as well as multidisciplinary approaches to treating patients with CRT devices...
July 12, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28700781/efficacy-and-safety-of-spironolactone-in-acute-heart-failure-the-athena-hf-randomized-clinical-trial
#3
Javed Butler, Kevin J Anstrom, G Michael Felker, Michael M Givertz, Andreas P Kalogeropoulos, Marvin A Konstam, Douglas L Mann, Kenneth B Margulies, Steven E McNulty, Robert J Mentz, Margaret M Redfield, W H Wilson Tang, David J Whellan, Monica Shah, Patrice Desvigne-Nickens, Adrian F Hernandez, Eugene Braunwald
Importance: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse neurohormonal activation in AHF. Objective: To assess the effect of high-dose spironolactone and usual care on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels compared with usual care alone. Design, Setting, and Participants: This double-blind and placebo (or low-dose)-controlled randomized clinical trial was conducted in 22 US acute care hospitals among patients with AHF who were previously receiving no or low-dose (12...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28685679/clinical-approach-to-diabetic-cardiomiopathy-a-review-of-human-studies
#4
Roberto Tarquini, Laura Pala, Simona Brancati, Giulia Vannini, Salvatore De Cosmo, Gianluigi Mazzoccoli, Carlo Maria Rotella
BACKGROUND: Diabetic Cardiomiopathy (DC) has been defined as a distinct entity characterized by the presence of diastolic or systolic cardiac dysfunction in a diabetic patient in the absence of other causes for Cardiomiopathy, such as coronary artery disease (CAD), hypertension (HTN), or valvular heart disease. Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population. Diabetes-related heart disease occurs in the form of coronary artery disease (CAD), cardiac autonomic neuropathy or DC...
July 5, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28695549/iron-substitution-in-the-treatment-of-chronic-heart-failure
#5
Christine Gstrein, Matthias Meyer, Pablo Anabitarte
Iron deficiency is a prevalent and clinically relevant comorbidity in up to 50% of patients with chronic heart failure (CHF). Iron deficiency in CHF patients is associated with impaired quality of life, reduced exercise capacity and increased mortality, irrespective of the presence of anaemia. It is diagnosed by determining circulating ferritin levels and transferrin saturation. Three randomised trials (CONFIRM-HF, FAIR-HF, and EFFECT-HF) of intravenous ferric carboxymaltose in the treatment of iron deficiency in CHF patients with reduced left ventricular ejection fraction demonstrated improvement of symptoms, functional capacity and quality of life...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28656517/treatment-of-hyperkalemia-in-heart-failure
#6
REVIEW
Ersilia M DeFilippis, Akshay S Desai
PURPOSE OF REVIEW: The aim of this paper is to discuss strategies for prevention and management of hyperkalemia in patients with heart failure, including the role of novel therapies. RECENT FINDINGS: Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) decrease mortality and morbidity in heart failure but increase the risk of hyperkalemia, especially when used in combination...
June 27, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28651783/optimal-timing-of-heart-transplant-after-heartmate-ii-left-ventricular-assist-device-implantation
#7
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
June 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28655192/right-ventricular-dysfunction-after-surgical-left-ventricular-restoration-prevalence-risk-factors-and-clinical-implications
#8
Lotte E Couperus, Victoria Delgado, Marieke E van Vessem, Laurens F Tops, Meindert Palmen, Jerry Braun, Harriëtte F Verwey, Robert J M Klautz, Martin J Schalij, Saskia L M A Beeres
OBJECTIVES: Surgical left ventricular (LV) restoration (SVR) induces changes in LV systolic and diastolic function that may affect postoperative right ventricular (RV) function. This study aimed to evaluate the long-term effect of SVR on RV function, with specific focus on determinants and prognostic implications of RV dysfunction. METHODS: Eighty-six patients (age 60 ± 10 years, 73% male) with clinical and echocardiographic follow-up 2 years after SVR were included...
June 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28634521/a-review-of-echocardiograms-in-hypertensive-patients-greater-than-60-years-in-a-community-based-family-medicine-program
#9
Shideh Doroudi, Michael D DeLisi, Vincent A DeBari
Background: Heart disease as a result of Hypertension is known to occur. Anatomical and functional changes of the heart can easily be detected by echocardiography, which is a safe and readily available study. Objectives: The aims of this study were to evaluate the prevalence of common echocardiographic changes in chronic hypertensive patients and to compare these changes in male and female populations. Design/methods: The study was a community-based cross-sectional study, on 227 hypertensive patients, 60 years and older, seen in St...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28625241/-efficacy-and-safety-of-intravenous-recombinant-human-brain-natriuretic-peptide-in-patients-with-severe-heart-failure-a-prospective-multicenter-clinical-study
#10
Xue Feng, Yue Wu, Ying Meng, Yizhen Wei
OBJECTIVE: To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). METHODS: A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade over III-IV, acute cardiac insufficiency and the acute exacerbation of chronic cardiac insufficiency admitted to intensive care unit/cardiovascular care unit (ICU/CCU) of 58 Hospitals in China were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28602367/heart-failure-with-preserved-ejection-fraction-in-older-adults
#11
REVIEW
Bharathi Upadhya, Dalane W Kitzman
Most elderly patients, particularly women, who have heart failure, have a preserved ejection fraction. Patients with this syndrome have severe symptoms of exercise intolerance, frequent hospitalizations, and increased mortality. Despite the importance of heart failure with preserved ejection fraction (HFpEF), the understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. Unlike the management of HFrEF, there is a paucity of large evidence-based trials demonstrating morbidity and mortality benefit for the treatment of HFpEF...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602368/use-of-diuretics-in-the-treatment-of-heart-failure-in-older-adults
#12
REVIEW
Domenic A Sica, Todd W B Gehr, William H Frishman
Diuretics are the most commonly prescribed class of drugs in patients with heart failure, and in the short term they remain the most effective treatment for relief from fluid congestion. This article reviews the mode of action of the various diuretic classes and the physiologic adaptations that follow and sets up the basis for their use in the treatment of volume-retaining states, particularly as applies to the elderly. In addition, the article reviews the common side effects related to diuretics.
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602373/cardiac-resynchronization-therapy-in-older-adults-with%C3%A2-heart-failure
#13
REVIEW
Phillip H Lam, George E Taffet, Ali Ahmed, Steve Singh
Heart failure is a disease of poor prognosis marked by frequent hospitalizations, premature death, and impaired quality of life. Despite advances in medical therapy for patients with heart failure and reduced ejection fraction, mortality and hospitalizations with advanced disease are still increased and the quality of life continues to be poor in this population. The advent of cardiac resynchronization therapy has led to a significant improvement in both survival and symptom management in patients with heart failure and reduced ejection fraction...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602374/treatment-of-ventricular-arrhythmias-and-use-of-implantable-cardioverter-defibrillators-to-improve-survival-in-older-adult-patients-with-cardiac-disease
#14
REVIEW
Jason T Jacobson, Sei Iwai, Wilbert S Aronow
Ventricular arrhythmia (VA) and sudden cardiac death (SCD) are well-recognized problems in the overall heart failure population, but treatment decisions can be more complex and nuanced in older patients. Sustained VA does not always lead to SCD, but identifies a higher risk population and may cause significant symptoms. Antiarrhythmic drugs (AAD) and catheter ablation are the mainstays for prevention of VA, but have not been shown to improve mortality. The value of implantable cardiac defibrillators (ICDs) may be influenced by patient age...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602369/heart-failure-complicating-acute-mtyocardial-infarction
#15
REVIEW
Wilbert S Aronow
Factors predisposing the older person with acute myocardial infarction (MI) to develop heart failure (HF) include an increased prevalence of MI, multivessel coronary artery disease, decreased left ventricular (LV) contractile reserve, impairment of LV diastolic relaxation, increased hypertension, LV hypertrophy, diabetes mellitus, valvular heart disease, and renal insufficiency. HF associated with acute MI should be treated with a loop diuretic. The use of nitrates, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, aldosterone antagonists, beta-blockers, digoxin, and positive inotropic drugs; treatment of arrhythmias and mechanical complications; and indications for use of implantable cardioverter-defibrillators and cardiac resynchronization is discussed...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28602365/role-of-echocardiography-in-the-diagnostic-assessment-and-etiology-of-heart-failure-in-older-adults-opacify-quantify-and-rectify
#16
REVIEW
Vedant A Gupta, Navin C Nanda, Vincent L Sorrell
Echocardiography allows the assessment of systolic and diastolic function and identifies many of the common causes of heart failure (HF). Patients with minimally symptomatic or unsuspected left ventricular systolic dysfunction may be identified and receive the benefits of angiotensin-converting enzyme inhibitor therapy. Echocardiography is also for assessing prognosis and can be used serially to evaluate treatment. Ventricular filling pressures, pulmonary artery pressures, and cardiac output can be sequentially determined...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28597798/ultrafiltration-versus-intravenous-loop-diuretics-in-patients-with-acute-decompensated-heart-failure-a-meta-analysis-of-clinical-trials
#17
Mohamad Kabach, Hassan Alkhawam, Sachil Shah, Georges Joseph, Elie M Donath, Noah Moss, Robert S Rosenstein, Robert Chait
Background Intravenous loop diuretics are the first-line therapy for acute decompensated heart failure (ADHF) but many patients are discharged with unresolved congestion resulting in higher re-hospitalization and mortality rates. Ultrafiltration (UF) is a promising intervention for ADHF. However, studies comparing UF to diuretics have been inconsistent in their clinical outcomes. Methods A comprehensive literature search was performed. Trials were included if they met the following criteria: (1) randomization with a control group, (2) comparison of UF with a loop diuretic, and (3) a diagnosis of ADHF...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28597803/prognostic-value-of-galectin-3-on-admission-in-chinese-patients-with-heart-failure-a-prospective-observational-study
#18
Hua Wang, Qingyong Chen, Yingying Li, Xianchao Jing, Tianya Liang, Jiefu Yang
Objective We performed a prospective observational study to explore the prognostic value of plasma galectin-3, a biomarker for fibrosis and inflammation, in Chinese patients with heart failure (HF). Methods and results Galectin-3, N-terminal pro B-type natriuretic peptide (NT-proBNP) and other clinically related variables were measured in consecutive HF patients in Beijing Hospital. Specifically, galectin-3 was detected by an enzyme-linked immunosorbent assay. The primary end point was major adverse cardiac events (MACE), including all-cause mortality or readmission at the end of follow-up...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28562571/hemodynamic-instability-after-pulmonary-veins-isolation-in-a-patient-with-dual-chamber-pacemaker-the-phantom-injury-of-the-ventricular-lead
#19
Márcio Galindo Kiuchi, Guilherme Miglioli Lobato, Shaojie Chen
INTRODUCTION: The standard treatment of sinus node dysfunction (SND) is the pacemaker implantation, and the ideal methodology for the management of atrial fibrillation (AF) is rhythm control, but this is sometimes very hard to accomplish. For such actions, complete isolation of all pulmonary veins (PVI) is currently widely accepted as the best endpoint. CASE PRESENTATION: In this case, we report a female patient, 81 years old, with controlled hypertension, without coronary artery disease, bearer of bilateral knee replacement, and dual chamber pacemaker implanted 1...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28570258/novel-method-for-exchange-of-impella-circulatory-assist-catheter-the-trojan-horse-technique
#20
Colin T Phillips, Hector Tamez, Thomas M Tu, Robert W Yeh, Duane S Pinto
Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device...
July 2017: Journal of Invasive Cardiology
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