Search results for "HEART"
showing 10 items of 3201 documents
Survival with Cardiac-Resynchronization Therapy in Mild Heart Failure
2014
BACKGROUND The Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT) showed that early intervention with cardiac-resynchronization therapy with a defibrillator (CRT-D) in patients with an electrocardiographic pattern showing left bundle-branch block was associated with a significant reduction in heart-failure events over a median follow-up of 2.4 years, as compared with defibrillator therapy alone. METHODS We evaluated the effect of CRT-D on long-term survival in the MADIT-CRT population. Post-trial follow-up over a median period of 5.6 years was assessed among all 1691 surviving patients (phase 1) and subsequently among 854 patients who w…
Usefulness and limitations of contractile reserve evaluation in patients with low-flow, low-gradient aortic stenosis eligible for cardiac resynchroni…
2014
Aims In low-flow, low-gradient aortic stenosis (LF/LG AS), the assessment of contractile reserve (CR) by dobutamine stress echocardiography (DSE) is recommended for risk stratification and treatment strategy. However, DSE may show limitations in cases of left ventricular dyssynchrony (LVD). The impact of LVD in LF/LG AS, and the feasibility of CRT in this setting have never been evaluated. We aimed to assess: (i) the proportion of LF/LG AS patients with LVD; (ii) the influence of LVD on CR at DSE; and (iii) the effects of CRT in these patients. Methods and results Thirty consecutive patients with LF/LG AS underwent DSE with study of CR. The operative risk for aortic valve replacement (AVR) …
Primary Persistent Atrial Fibrillation: A Distinct Arrhythmia Subentity of an Ablation Population
2015
INTRODUCTION Persistent atrial fibrillation (persAF) can occur either as a sustained arrhythmia that has progressed from initially paroxysmal AF or as primary persAF without a history of any spontaneously terminated episode. There is a paucity of data differentiating between the 2 different persAF entities. Thus, we prospectively evaluated baseline characteristics, electrophysiological features, and ablation outcome in these 2 patient cohorts. METHODS AND RESULTS A total number of 154 consecutive persAF patients (63 ± 10 years, f = 42, longstanding persAF = 60) were characterized in terms of having primary persAF (P-persAF group) or persAF that secondarily progressed from paroxysmal AF (S-p…
Effects of empagliflozin on CA125 trajectory in patients with chronic congestive heart failure
2021
INTRODUCTION: We aimed to evaluate the trajectory of two surrogates of fluid overload -antigen carbohydrate 125 (CA125) and amino-terminal pro-brain natriuretic peptide (NT-proBNP)- after the addition of oral empagliflozin to usual care in a cohort of patients with chronic heart failure (CHF) and type 2 diabetes (T2D). METHODS AND RESULTS: From October 2015 to February 2019, 60 ambulatory patients with CHF and T2D were retrospectively included. The primary endpoint was to assess the longitudinal trajectory of plasma levels of CA125 and NT-proBNP after empagliflozin initiation. Changes in quantitative variables were evaluated using linear mixed regression. Median CA125 and NT-proBNP at basel…
Carbohydrate Antigen-125–Guided Therapy in Acute Heart Failure
2016
Abstract Objectives This study sought to evaluate the prognostic effect of carbohydrate antigen-125 (CA125)–guided therapy (CA125 strategy) versus standard of care (SOC) after a hospitalization for acute heart failure (AHF). Background CA125 has emerged as a surrogate of fluid overload and inflammatory status in AHF. After an episode of AHF admission, elevated values of this marker at baseline as well as its longitudinal profile relate to adverse outcomes, making it a potential tool for treatment guiding. Methods In a prospective multicenter randomized trial, 380 patients discharged for AHF and high CA125 were randomly assigned to the CA125 strategy (n = 187) or SOC (n = 193). The aim in th…
Endothelial Bmx tyrosine kinase activity is essential for myocardial hypertrophy and remodeling
2015
Cardiac hypertrophy accompanies many forms of heart disease, including ischemic disease, hypertension, heart failure, and valvular disease, and it is a strong predictor of increased cardiovascular morbidity and mortality. Deletion of bone marrow kinase in chromosome X (Bmx), an arterial nonreceptor tyrosine kinase, has been shown to inhibit cardiac hypertrophy in mice. This finding raised the possibility of therapeutic use of Bmx tyrosine kinase inhibitors, which we have addressed here by analyzing cardiac hypertrophy in gene-targeted mice deficient in Bmx tyrosine kinase activity. We found that angiotensin II (Ang II)-induced cardiac hypertrophy is significantly reduced in mice deficient i…
Safety and efficacy of exercise testing with atropine in patients with recent uncomplicated ST elevation acute myocardial infarction
2012
Background: Exercise testing (ET) remains the most accessible and widely used technique for the detection of coronary artery disease (CAD) and for the assessment of its severity. Failure to reach 85% of maximal predicted heart rate (MPHR) during exercise may render an ET nondiagnostic for ischemia detection in patients with recent uncomplicated ST elevation acute myocardial infarction (STEMI). We sought to investigate the injection of atropine in patients who fail to achieve 85% of age-predicted heart rate during ET, defining its safety and efficacy to raise heart rate to adequate levels as well as to determine its effect on ET interpretation. Methods: Between January 2005 and December 2008…
Anemia, heart failure and exercise training
2013
We read with interest the recent article by Wang et al. in which theauthors evaluated in anemic patients with heart failure whether exer-tionalperiodicbreathing influences rheological/hemodynamicfunctions[1]. For this purpose, the authors performed an incremental exercisetestusing a bicycle ergometer. In this regard, it has been generally assumedby some researchers, exercise physiologists and scientists that the incre-ment in blood hemoglobin (Hb) content is among the main hematolog-ical adaptations to endurance exercise training. This misconception isbased in the data published in diffe rent studies carried out severalyearsago [2].Inarecentmanuscript byBakeretal. [3],theauthorsdem-onstrated…
Viridans streptococcal infective endocarditis associated with fixed orthodontic appliance managed surgically by mitral valve plasty
2018
Abstract Rationale: Streptococcus viridans, a heterogeneous group of alpha-hemolytic streptococci, is part of the normal flora of the mouth, usually responsible for dental caries (Streptococcus mutans, Streptococcus sanguinis), and pericoronitis, as well as for subacute infective endocarditis. They are responsible for 40-60% of the endocarditis cases occurring on the normal valves, especially in male patients and over 45 years of age. A change in the bacterial flora of the oral cavity is taking part after orthodontic fixed appliances are introduced into the oral cavity, change that is associated with an increased concentration of the acidogenic bacteria. Bacteraemia is the consequence of or…
Coronary CT angiography: a guide to examination, interpretation, and clinical indications
2021
Introduction: The introduction of Cardiac Computed Tomography (CCT) has changed the paradigm in the field of diagnostic cardiovascular medicine. CCT is the primary tool in the assessment of suspected Coronary Artery Disease (CAD) and should be followed by functional assessment when needed to stratify disease and to plan potential interventional or surgical therapy. Areas Covered: We provided the current state of the knowledge on the main aspects of technique of examination, image interpretation and clinical indications. We have focused our attention on the basic routine applications and activities. Expert Opinion: The primary role of CCT in suspected CAD will progressively become the standa…