Treating the Cardiorenal Syndrome: A Sledgehammer for a Needle's Work?

When providing care for the patient with advanced heart failure (HF), both diuretic resistance and worsening renal function (i.e. cardiorenal syndrome) are common occurrences associated with poor outcomes.1, 2 When the rise in intravascular volume in decompensated HF exceeds the venous bed compliance, a venous backpressure in the kidney will occur. The ability of the kidneys to excrete salt and water in decompensated HF is to some degree related to this venous backpressure out of the kidney as well as the forward arterial perfusion into the kidney.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: Editorial Comment Source Type: research

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We report the history of a 68-year-old man who underwent implantation of an HeartMate 3TM as a bridge to transplantation. Nineteen months later, he developed signs of heart failure leading to cardiogenic shock. Neither clinical examination nor parameters from the device allowed a clear-cut diagnosis. Only surgical exploration revealed the presence of clots between the polyethylene terephthalate (Dacron®) and polytetrafluoroethylene tubes. This constitutes a weakness of this device for which we propose to the manufacturer for minimal modifications to overcome the problem. PMID: 31814521 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Microvascular obstruction is a common repercussion of percutaneous coronary intervention for distal microembolization, ischemia –reperfusion injury and inflammation, which increases post-myocardial infarction heart failure and mortality. Ultrasound-targeted microbubble cavitation (UTMC) may resolve microvascular obstruction while activating endothelial nitric oxide synthase (eNOS) and increasing endothelium-derived nitric oxide (NO) bioavailability. Nitrite, a cardioprotective agent, offers an additional source of NO and potential synergy with UTMC.
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Original Contribution Source Type: research
In conclusion, T2D impairs vascular function by dysregulated autophagy. Therefore, autophagy could be a potential target for overcoming diabetic microvascular complications. To What Degree Does Loss of Skeletal Muscle with Age Contribute to Immunosenescence? https://www.fightaging.org/archives/2019/11/to-what-degree-does-loss-of-skeletal-muscle-with-age-contribute-to-immunosenescence/ Sarcopenia, the progressive loss of muscle mass and strength, is characteristic of aging. A perhaps surprisingly large fraction of the losses can be averted by strength training, but there are nonetheless inexorable process...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Introduction: Pulmonary hypertension (PH) is a rare complication of hereditary hemorrhagic telangiectasia (HHT). This is usually a post-capillary PH (group 2), due to high cardiac output and leading to left-heart failure. More rarely, it can result from pulmonary vascular remodeling (pre-capillary PH). We investigated prevalence, hemodynamic profiles and associated clinical conditions of pre-capillary PH associated with HHT.Methods: We conducted a retrospective monocentric study in the French national reference center (Lyon, France) among patients with confirmed HHT who underwent right heart catheterization (RHC). Patients...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
Backgrounds: Chronic thromboembolic disease (CTED) is characterized by similar symptoms and perfusion defect as chronic thromboembolic pulmonary hypertension (CTEPH), but without pulmonary hypertension at rest. Recently, successful pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA) for symptomatic patients with CTED has been reported. However, it remains unclear whether CTED evolves to CTEPH. The aim of this study is to clarify the natural history of CTED.Methods: Consecutive patients diagnosed as CTED between 1986 and 2017 were retrospective enrolled. CTED was defined as follows: a mean pulmonary arterial pressure at rest
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
PAH is characterized by impaired pulmonary gas exchange, with worsening of ventilation/perfusion ratio and increase in physiological dead space. In our Institute, we developed a rehabilitation program for PAH patients with aerobic, resistive and breathing exercises, including CB sessions. CB resulted useful in conditions characterized by a gas exchange impairment as chronic obstructive pulmonary disease, heart failure and high altitude hypoxia, improving oxygenation and vagal activity and concomitantly reducing sympathoexcitation, with a favorable effect on symptoms and prognostic variables.Our purpose is to evaluate the p...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and chronic care Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
The objective of this study was to determine if pulse oximeter accuracy is dependent on location in heart failure patients during peak exercise.Methods20 participants with HF (7F, age 64.±11 yr) and 9 participants with coronary artery disease as controls (CAD: 3F, age 66±5 yr) performed a maximal exertion treadmill exercise stress test while wearing both finger and forehead pulse oximeters.ResultsAt peak exercise, the two pulse oximeters measurements of SpO2 differed from each other by 3.8 ± 3.3% in the HF group (p
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
The brain is an energy-hungry organ, and is sensitive to reductions in the blood supply of oxygen and nutrients. Cardiovascular aging can reduce that supply, whether through conditions such as heart failure, or the progressive loss of density in capillary networks that occurs throughout the body with advancing age, or an accelerated pace of rupture of tiny vessels in the brain, or disruption of the blood-brain barrier, allowing unwanted molecules and cells to enter the brain. Thus, as researchers here note, we would expect to see correlations between cardiovascular disease, or risk factors for cardiovascular disease, and d...
Source: Fight Aging! - Category: Research Authors: Tags: Daily News Source Type: blogs
We report the first case providing insight on how improved perfusion might translate into improved myocardial function as assessed by cardiac magnetic resonance strain imaging, thus suggesting a physiological rationale to test CS Reducer in the setting of ischemic cardiomyopathy with reduced ejection fraction and adverse remodeling.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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