Many heart failure patients don ’t recognize the risks of their illness
(Reuters Health) - Even though doctors think most people with heart failure have a high likelihood of requiring a heart transplant or dying from complications of their illness, a small U.S. study suggests that many patients see a much rosier picture of their future.
Authors: Koulova A, Gass AL, Patibandla S, Gupta CA, Aronow WS, Lanier GM Abstract Pulmonary hypertension in left heart disease (PH-LHD) commonly complicates prolonged heart failure (HF). When advanced, the PH becomes fixed or out of proportion and is associated with increased morbidity and mortality in patients undergoing orthotopic heart transplant (OHT). To date, the only recommended treatment of out of proportion PH is the treatment of the underlying HF by reducing the pulmonary capillary wedge pressure (PCWP) with medications and often along with use of mechanical circulatory support. Medical therapies typical...
AbstractPurpose of ReviewHeart failure is increasing in prevalence with a lack of recently developed therapies that produce major beneficial effects on its associated mortality. MicroRNAs are small non-coding RNA molecules that regulate gene expression, are differentially regulated in heart failure, and are found in the circulation serving as a biomarker of heart failure.Recent FindingsData suggests that microRNAs may be used to detect allograft rejection in cardiac transplantation and may predict the degree of myocardial recovery in patients with a left ventricular assist device or treated with beta-blocker therapy. Given...
In conclusion, composite measures based on non-invasive parameters, such as IVC%/TAPSE, RVSP/TAPSE and RA × IVCinsp/S’RV, may provide equally accurate prognosis as the invasive examination. PCWP and CI determined during RHC were the best individual predictors of the composi te endpoint. In addition, echocardiographic parameters: RVD, RA, IVC, TAPSE, and S’RV are accurate predictors of the unfavorable outcome.
Conclusion Doppler SVI correlated with CMRI SVI in patients with systemic LV and systemic RV. The association between output measures (SVI and CI) and FAD were seen only in single LV patients (single RV patients not assessed for this outcome due to small numbers). An association between low Doppler CI and Fontan failure was suggested in a small number of single LV patients.
Conclusions: Cardiopulmonary exercise testing is feasible in children with DCM and is useful to predict outcomes. The finding of lower exercise capacity and lower blood pressure response should prompt closer follow-up. In those with serial testing, a decline in exercise capacity may be a marker of clinical deterioration.
ConclusionFrailty decreased in approximately half of older adults with advanced heart failure after 6 months of LVAD support. Strategies to enhance frailty reversal in this population are worthy of additional study.
We report a rare case of giant cell myocarditis in a 64-year-old previously healthy woman. The case was complicated by the rapid development of progressive acute heart failure, which required the comprehensive care of our heart team. Using a broad spectrum of therapeutic approaches, the patient successfully underwent heart transplantation.
Researchers here report on a cheaper implementation of encapsulation for transplanted stem cells, preventing the recipient's immune system from attacking cells originating from a different individual or even different species. Since the stem cells produce improvement in regeneration in heart tissue via signaling, there is no need to expose the cells themselves to the local environment - the cells are only needed at all because the signaling environment is not yet fully mapped and understood. Encapsulating transplanted cells in a nanogel extends their lifetime and thus the therapeutic effect. As a promising approa...
Continuous-flow ventricular assist devices (CF-VAD) have been widely used in end-stage heart failure in adult patients for both bridge to transplantation and destination therapy. Technology improvement has enabled miniaturization of the CF-VAD, which may greatly benefit the pediatric patients with sufficient body size in advanced heart failure. There are still, however, challenging situations for CF-VAD implantation, such as in single ventricle physiology, anatomically abnormal heart, small children and infants.
Background: Severe heart failure (HF) patients often have renal dysfunction because of low cardiac output. Methods and Results: 39 patients underwent a centrifugal-type, continuous-flow left ventricular assist device (LVAD) (EVAHEART) implantation as a bridge to cardiac transplantation at our institute between 2005 and 2015. We investigated the changes in renal function over 2 years among 36 patients with supported by EVAHEART over 6 months. The median estimated glomerular filtration rate (eGFR) at implantation was 62 ± 32 mL/min/1.73 m2 and 47% of the patients showed eGFR