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Cardio ❤️

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Sripal Bangalore, David J Maron, Judith S Hochman
No abstract text is available yet for this article.
November 10, 2015: JAMA: the Journal of the American Medical Association
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
G Michael Felker, Kerry L Lee, David A Bull, Margaret M Redfield, Lynne W Stevenson, Steven R Goldsmith, Martin M LeWinter, Anita Deswal, Jean L Rouleau, Elizabeth O Ofili, Kevin J Anstrom, Adrian F Hernandez, Steven E McNulty, Eric J Velazquez, Abdallah G Kfoury, Horng H Chen, Michael M Givertz, Marc J Semigran, Bradley A Bart, Alice M Mascette, Eugene Braunwald, Christopher M O'Connor
BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients with acute decompensated heart failure to receive furosemide administered intravenously by means of either a bolus every 12 hours or continuous infusion and at either a low dose (equivalent to the patient's previous oral dose) or a high dose (2...
March 3, 2011: New England Journal of Medicine
Helene von Bibra, Walter Paulus, Martin St John Sutton
Approximately 50 % of patients with heart failure have diastolic heart failure (HFPEF) with the major predisposing risk factors age, inactivity, obesity, insulin resistance (IR), type-2 diabetes, and hypertension. The prognosis of HFPEF is comparable to that of systolic heart failure, but without any specific or effective treatment. This review presents a biomathematically corrected diagnostic approach for quantification of diastolic dysfunction (DD) via the age dependency of diastolic function. Pathophysiological mechanisms for DD in the cardiometabolic syndrome (CMS) are mainly based on downstream effects of IR including insufficient myocardial energy supply...
August 18, 2016: Current Heart Failure Reports
Ann Marie Navar, Michael J Pencina, Eric D Peterson
Importance: The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated the benefit of lowering systolic blood pressure (SBP) to 120 mm Hg, yet other trials, such as Heart Outcomes Prevention Evaluation-3 (HOPE-3), did not find consistent benefit. How to incorporate these results into the treatment of those with elevated SBP in the general population is not clear. Objectives: To assess the representativeness of SPRINT and HOPE-3 relative to patients in the United States and to explore the cardiovascular disease (CVD) risk profiles of various populations with elevated SBP...
September 7, 2016: JAMA Cardiology
Ben Freedman, Tatjana S Potpara, Gregory Y H Lip
Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K antagonist anticoagulants...
August 20, 2016: Lancet
V Koenig-Oberhuber, M Filipovic
In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this review, the authors discuss the most important antiplatelet and anticoagulant drugs, the perioperative management, the handling of bleeding complications, and the interpretation of some laboratory analyses related to these agents...
September 2016: British Journal of Anaesthesia
Mustafa Kilickap, Jackie Bosch, John W Eikelboom, Robert G Hart
Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are previous stroke and age ≥ 75 years. Canadian guidelines recommend anticoagulant therapy for patients with AF who are older than the age of 65 years, but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagulants appear to be safer, at least as efficacious, and more convenient than warfarin, and are a cost-effective alternative for elderly patients with AF...
September 2016: Canadian Journal of Cardiology
Anthony S McLean
Echocardiography is pivotal in the diagnosis and management of the shocked patient. Important characteristics in the setting of shock are that it is non-invasive and can be rapidly applied.In the acute situation a basic study often yields immediate results allowing for the initiation of therapy, while a follow-up advanced study brings the advantage of further refining the diagnosis and providing an in-depth hemodynamic assessment. Competency in basic critical care echocardiography is now regarded as a mandatory part of critical care training with clear guidelines available...
2016: Critical Care: the Official Journal of the Critical Care Forum
Grant W Reed, Jeffrey E Rossi, Christopher P Cannon
Acute myocardial infarction has traditionally been divided into ST elevation or non-ST elevation myocardial infarction; however, therapies are similar between the two, and the overall management of acute myocardial infarction can be reviewed for simplicity. Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide, despite substantial improvements in prognosis over the past decade. The progress is a result of several major trends, including improvements in risk stratification, more widespread use of an invasive strategy, implementation of care delivery systems prioritising immediate revascularisation through percutaneous coronary intervention (or fibrinolysis), advances in antiplatelet agents and anticoagulants, and greater use of secondary prevention strategies such as statins...
August 5, 2016: Lancet
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos Filippatos, Gregg C Fonarow, Michael M Givertz, Steven M Hollenberg, JoAnn Lindenfeld, Frederick A Masoudi, Patrick E McBride, Pamela N Peterson, Lynne Warner Stevenson, Cheryl Westlake
No abstract text is available yet for this article.
September 27, 2016: Circulation
Gregory Y H Lip, Benjamin J Wrigley, Ron Pisters
No abstract text is available yet for this article.
2016: Cochrane Database of Systematic Reviews
Colleen K McIlvennan, Larry A Allen
Despite advances in cardiac therapy, heart failure (HF) remains a progressive, highly symptomatic, and deadly disease that places great demands on patients, caregivers, and healthcare systems. Palliative care is a multidisciplinary approach to care that focuses on communication, shared decision making, and advance care planning; provides relief from pain and other distressing symptoms; integrates psychological and spiritual aspects of care; and offers a support system to help families cope during illness and bereavement...
2016: BMJ: British Medical Journal
Ravi Korabathina
Acute decompensated heart failure (HF) is one of most common reasons for hospitalization among individuals older than 65 years. A thorough evaluation, including history, physical examination, and laboratory assessment, is required to optimize care of these patients. In uncertain cases, serum brain-type natriuretic peptide (BNP) or N-terminal proBNP level, stress testing, and/or invasive coronary angiography may be helpful in establishing the diagnosis. The hospital setting provides an opportunity to identify etiologies and stabilize the patient...
March 2016: FP Essentials
Daniel Eckstein, Ravi Korabathina
Heart failure (HF) is a complex clinical condition. The newer guidelines have phased out the designations of systolic and diastolic HF and replaced them with the more physiologically applicable classifications of HF with reduced or preserved ejection fraction (EF). Although the numbers of new patients within these two groups are similar, patient characteristics and risk factors often differ. There also are differences in the incidence of HF among racial and ethnic groups, with blacks having the highest incidence...
March 2016: FP Essentials
Muhammad Rizwan Sardar, Wajeeha Saeed, Peter R Kowey
Atrial fibrillation (AF) is the most frequently encountered arrhythmia. Prevalence increases with advancing age and so as its associated comorbidities, like heart failure. Choice of pharmacologic therapy depends on whether the goal of treatment is maintaining sinus rhythm or tolerating AF with adequate control of ventricular rates. Antiarrhythmic therapy and conversion of AF into sinus rhythm comes with the side effect profile, and we should select best antiarrhythmic therapy, individualized to the patient...
April 2016: Heart Failure Clinics
Sripal Bangalore, Robert Fakheri, Bora Toklu, Franz H Messerli
OBJECTIVE: To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. DESIGN: Meta-analysis. DATA SOURCES AND STUDY SELECTION: PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, and end stage renal disease...
2016: BMJ: British Medical Journal
Nathanial S Nolan, Scott M Koerber, Sudarshan Balla
No abstract text is available yet for this article.
March 2016: JAMA Internal Medicine
Ziad Nehme, Dion Stub, Stephen Bernard, Michael Stephenson, Janet E Bray, Peter Cameron, Ian T Meredith, Bill Barger, Andris H Ellims, Andrew J Taylor, David M Kaye, Karen Smith
OBJECTIVE: Supplemental oxygen therapy may increase myocardial injury following ST-elevation myocardial infarction (STEMI). In this study, we aimed to evaluate the effect of the dose and duration of oxygen exposure on myocardial injury after STEMI. METHODS: Descriptive analysis of data from a multicentre, prospective, randomised, controlled trial of 441 patients with STEMI randomised to supplemental oxygen therapy or room air breathing. The primary endpoint was myocardial infarct size as assessed by cardiac biomarkers, troponin (cTnI) and creatine kinase (CK)...
March 2016: Heart: Official Journal of the British Cardiac Society
2016-09-13 20:48:40
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