Primary mechanical unloading in high-risk myocardial infarction: Perspectives in view of a paradigm shift
The improvement achieved in recent years in early myocardial infarction (MI) mortality poses several new clinical challenges, owing to late consequences of myocardial loss and the significant incidence of heart failure (HF) observed thereafter. A still unaddressed residual reperfusion injury (RI) contributes to final infarct size, acute MI mortality and longer-term HF development. Despite many cardioprotective lines of research in the setting of MI, no treatment has significantly altered clinical practice or convincingly improved outcomes either.
This article describes a patient who presented with an ST-segment elevation myocardial infarction that quickly developed into acute cardiogenic shock refractory to conventional medical therapy. Extracorporeal membrane oxygenation was used to manage the patient's heart failure and bridge to a long-term left ventricular assist device.
Coronary artery disease (CAD) is a life-threatening condition that, unless treated at an early stage, can lead to congestive heart failure, ischemic heart disease, and myocardial infarction. Early detection of diagnostic features underlying electrocardiography signals is crucial for identifying and treating of CAD. In the present work, we proposed novel entropy called Renyi Distribution Entropy (RdisEn) for the analysis of short-term heart rate variability (HRV) signals and the detection of CAD. Our simulation experiment with synthetic, physiological, and pathological signals demonstrated that RdisEn could distinguish effe...
Conclusion: GFR-specific risk-based cutoffs for PTH1 –84 and FGF-23 may facilitate more meaningful risk stratification in advanced CKD than current GFR-agnostic reference ranges derived from healthy adults. This may be most applicable in those with severely reduced GFR.Am J Nephrol
Conclusion: The HEDIS data underreported hospital admissions for 3 common medical conditions, and readmission rates were higher among patients with underreported admissions. Medicare Advantage beneficiaries had higher risk-adjusted 30-day readmission rates than traditional Medicare beneficiaries. Primary Funding Source: National Institute on Aging. PMID: 31234205 [PubMed - as supplied by publisher]
Conclusion: Circulating microRNA-1 is capable of early diagnosis of NSTEMI in patients with CKD suffering from chest pain.Cardiorenal Med
Background: Ventricular remodeling is a significant contributor to development of heart failure in post myocardial infarction (MI) setting. However, data on time course assessment of ventricular remodelling is still lacking.
Sensing and transducing mechanical signals from the cellular microenvironment is essential for controlling cell fate and maintaining cell function, however the mechanical properties of this environment can be pathologically altered by disease. For example, the stiffness of myocardium is dramatically increased following myocardial infarction and this change is associated with the progression of heart disease towards heart failure. To appreciate the contribution of aberrant mechanical signals to disease progression, it is crucial to understand mechanosensation across a physio- pathological range.
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
ConclusionsA different role for the AGE-RAGE axis was observed in HF and ACS. All the sRAGE forms were directly related with glycation parameters in HF, but not in ACS. The independent value of the sRAGE forms on each cardiovascular disease was supported by esRAGE being an independent predictor of bad long-term prognosis only for HF.
Publication date: Available online 21 June 2019Source: Canadian Journal of CardiologyAuthor(s): Mark Canney, Mila Tang, Lee Er, Sean J. Barbour, Ognjenka Djurdjev, Adeera Levin, CanPREDDICT InvestigatorsAbstractBackgroundUsing standard cut-offs derived from healthy adults, high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are frequently elevated in patients with reduced glomerular filtration rate (GFR), with unclear implications. We sought to compare GFR-specific cut-offs of each biomarker to standard cut-offs for discrimination of cardiovascular risk in asymptomatic pa...