Outcomes of orthotopic heart transplantation and left ventricular assist device in patients aged 65 years or more with end-stage heart failure.

Outcomes of orthotopic heart transplantation and left ventricular assist device in patients aged 65 years or more with end-stage heart failure. Proc (Bayl Univ Med Cent). 2019 Apr;32(2):177-180 Authors: Harmon DM, Tecson KM, Jamil AK, Felius J, Gonzalez-Stawinski GV, Joseph SM, Hall SA Abstract Age has traditionally been a limiting factor for advanced heart failure (HF) therapies. Orthotopic heart transplantation (OHT) age guidelines have become less restrictive, and left ventricular assist devices (LVADs) are increasingly utilized as destination therapy for patients ≥65 years. Although indications differ, we assessed outcomes for both modalities in this older population. We reviewed charts of consecutive advanced HF therapy recipients aged ≥65 years at our center from 2012 to 2016. Of 118 patients evaluated, 46 (39%) received an LVAD and 72 (61%) received OHT. Gender, body mass index, and rate of prior sternotomy were similar between groups; OHT recipients were younger, less likely to have diabetes mellitus, and more likely to have HF due to ischemic etiology. Forty-six percent of patients receiving LVADs were urgent need (Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS] profile 1-2), compared to 29% of patients receiving OHT (United Network for Organ Sharing 1A criteria; P = 0.068). OHT recipients had shorter lengths of stay and better 1-year survival compared to LVAD recipients. Although many centers d...
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research

Related Links:

We present a case of a patient with HT who presented with acute decompensated CHF (ADCHF) secondary to uncontrolled DM.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 318 Source Type: research
Diabetes mellitus (DM) is associated with increased mortality in advanced heart failure and in patients undergoing cardiac surgery. However, its impact on outcomes in patients supported with left ventricular assist devices (LVAD) is not well established. We queried the United Network for Organ Sharing (UNOS) for all adults listed for heart transplantation and bridged with continuous-flow LVAD in the United States from 2000 to 2015. We compared the pre- and post-transplant mortality of patients with and without DM. Unadjusted and adjusted time-event analyses were performed. A total of 4,978 patients were included in this an...
Source: ASAIO Journal - Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
Nature Reviews Nephrology, Published online: 24 June 2019; doi:10.1038/s41581-019-0173-0Sodium–glucose cotransporter 2 inhibitors (SGLT2i) have been recommended for the treatment of patients with type 2 diabetes mellitus and cardiovascular disease, heart failure or chronic kidney disease. Findings from recent efficacy and safety trials of empagliflozin in kidney transplant recipients with post-transplantation diabetes are timely, given the elevated cardiovascular risk associated with solid organ transplantation.
Source: Nature Reviews Nephrology - Category: Urology & Nephrology Authors: Source Type: research
Council on Cardiovascular and Stroke Nursing; and the Heart Failure Society of America Abstract Type 2 diabetes mellitus is a risk factor for incident heart failure and increases the risk of morbidity and mortality in patients with established disease. Secular trends in the prevalence of diabetes mellitus and heart failure forecast a growing burden of disease and underscore the need for effective therapeutic strategies. Recent clinical trials have demonstrated the shared pathophysiology between diabetes mellitus and heart failure, the synergistic effect of managing both conditions, and the potential for diabetes ...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Crohn’s Disease in Clinical Remission Is Marked by Systemic Oxidative Stress Arno R. Bourgonje1, Julius Z. H. von Martels1, Marian L. C. Bulthuis2, Marco van Londen3, Klaas Nico Faber1, Gerard Dijkstra1† and Harry van Goor2*† 1Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 2Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 3Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Gro...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusion The high prevalence of comorbidities in patients with stroke indicates the need for therapies in preclinical studies that take into account these comorbidities in order to avoid failures in translation to the patient. Preclinical studies are beginning to evaluate the efficacy of MSC treatment in stroke associated with comorbidities, especially hypertension, for ischemic and hemorrhagic stroke. Regarding aging and diabetes, only ischemic stroke studies have been performed. For the moment, few studies have been performed and contradictory results are being reported. These contradictory results may be due to the u...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Diabetes mellitus (DM) is a known risk factor for increased mortality in advanced heart failure and in those undergoing cardiac surgery. However, there is paucity of large-scale data on its influence on outcomes in patients undergoing left ventricular assist device (LVAD) implantation. We sought to determine the impact of DM on in-hospital outcomes after LVAD placement.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 177 Source Type: research
This study sought to investigate the effect of preoperative DM on all-cause mortality and major postoperative complications in patients with LVAD.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 866 Source Type: research
AbstractPurpose of ReviewDue to advancements in oncologic treatment strategies and techniques, the number of survivors who have undergone hematopoetic stem cell transplant (HCT) continues to increase in the United States; this number is projected to reach 502,000 by the year 2030. There is significant interest within the field of cardio-oncology to identify cardiotoxicity and cardiovascular disease in the HCT population. Epidemiologic studies analyzing both short- and long-term cardiovascular effects, risk stratification modeling, cardioprotective strategies, and expert consensus documents for cardiotoxicity surveillance r...
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: Despite attempts to reduce cardiotoxicity in childhood cancer treatment, CVD risks in ALL survivors treated more recently do not seem to have declined. PMID: 30852834 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
More News: Cardiology | Diabetes | Diabetes Mellitus | Endocrinology | Heart | Heart Failure | Heart Transplant | Transplants | Universities & Medical Training