2020 ACC/HFSA/ISHLT Lifelong Learning Statement for Advanced Heart Failure and Transplant Cardiology Specialists

Since the publication of its first Core Cardiovascular Training Statement (COCATS) in 1995,1 the American College of Cardiology (ACC) has defined the knowledge, experiences, skills, and behaviors expected of clinical cardiologists. Subsequent revisions have moved toward competency-based training based on the 6-domain competency structure promulgated by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties and endorsed by the American Board of Internal Medicine (ABIM).
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: LIFELONG LEARNING STATEMENT Source Type: research

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We appreciate Dr. Houston's consideration of whether circulating Endothelin-1 ’s (ET1) hypothesized role in the Anrep effect could explain our findings of a lower risk for incident heart failure in healthy subjects.1 The Anrep effect describes the observation that sustained elevation in left ventricular end-diastolic volume leads to increases in myocardial contractility and ventricular unloading over many minutes, which is distinct from the more rapid Frank-Starling mechanism. On a tissue level, the Anrep effect may stem from slow force response (SFR) whereby myocardial stretch causes increased calcium transient ampl...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Editorial Source Type: research
Three otherwise healthy patients go to the emergency department with severe acute respiratory failure. Only one ventilator, required to sustain life until the worst of the coronavirus infection has passed, is available. Who gets the vent? That’s what “A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic,” a Viewpoint just published in the Journal of the American Medical Association (JAMA), addresses. Douglas White, MD, MAS, Endowed Chair for Ethics in Critical Care Medicine at the University of Pittsburgh School of Medicine ...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care Author: Lewis syndicated Source Type: blogs
For patients with advanced heart failure (HF), left ventricular assist device implantation as destination therapy (DT-LVAD) is potentially life prolonging, but comes with risks and burdens. Additionally, not all candidates will ultimately be medically appropriate for treatment due to various relative and absolute contraindications.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Research Correspondence Source Type: research
END-STAGE heart failure remains one of the leading causes of hospitalization in patients older than 65 years and carries a 50% mortality within 5 years of initial diagnosis.1 Heart transplantation once was believed to be associated with increased morbidity; however, dramatic advancements in immunosuppression and preservation techniques have contributed to a significant improvement in survival. One-year survival after heart transplantation in the 1980s was as low as 76%, whereas now it has improved to 85%, with many experienced centers reporting even higher rates.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
AbstractHeart transplantation (HT) in patients with prior cardiovascular implantable electronic devices (CIEDs) is becoming more common, in parallel with the increased use of CIEDs for patients with advanced heart failure. Complete removal of CIED components during HT is not always feasible, and it is thus surprising that the literature addressing the implications of retained CIED components is limited. Indeed, there are neither guidelines nor consensus regarding the need for removal of these CIED fragments. This issue is nonetheless becoming important in light of the increase in the percentage of HT candidates having CIED...
Source: Infection - Category: Infectious Diseases Source Type: research
OVER THE last few decades, the number of patients being listed for heart transplant has been growing, although the number of available donor organs has remained relatively constant.1 As the population ages, an increasing volume of patients is expected to develop advanced heart failure and become eligible for heart transplant. This widening gap in supply and demand warrants careful patient selection to optimize these most precious resources. Accordingly, the ideal system to allocate donor organs to prospective recipients simultaneously should minimize mortality for patients on the waiting list and maximize post-transplant s...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Pro and Con Source Type: research
i A Abstract Background: Apolipoprotein M (APOM) mediates the physical interaction between high-density lipoprotein (HDL) particles and sphingosine-1-phosphate (S1P). APOM exerts anti-inflammatory and cardio-protective effects in animal models. Methods: In a subset of Penn-HF study (PHFS) participants (n=297), we measured APOM by ELISA. We also measured total S1P by liquid chromatography-mass spectrometry and isolated HDL particles to test the association between APOM and HDL-associated S1P. We confirmed the relationship between APOM and outcomes using modified aptamer-based APOM measurements, among 2,170 adults i...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Authors: Corrà U, Piepoli M, Giordano A Abstract Exercise oscillatory ventilation (EOV) is an ominous sign in heart failure due to reduced left ventricular ejection fraction (HFrEF) whatever it is represented. But EOV is detected also in normal healthy individuals and in other cardiovascular disease (CVD) patients, however, its prevalence in these is not completed clear. The aim was to describe the occurrence of EOV in healthy subjects and the overall population all CVD patients who performing symptom limited cardiopulmonary exercise testing (CPET). Healthy subjects were divided in athletes and normal subjec...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
In the era of increased left ventricular support device (LVAD) implantation, limited data is available on outcomes in the obese population, with most available data describing elevated BMI with a cutoff of>30 kg/m2. Forest et al examined the ISHLT Mechanically Assisted Circulatory Support (IMACS) registry and found no impact in 2-year mortality in those with higher BMIs, but an increase in all adverse events describing BMI> 40 kg/m2 group. We seek to provide our experience with this population.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (69) Source Type: research
The objectives of this study were to describe survival, characterize rates of adverse events (AEs) and compare survival after an AE in patients age ≥70 vs. age 50-69.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (67) Source Type: research
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