In Reply, Endothelin-1 and the Anrep Effect
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 amplitude and enhanced contractility.
Cardiac Cancer (CC) that arises from or involves the heart can present as heart failure, chest pain, stroke or another thromboembolic event. Although patients with CC have limited treatment options, in other organ cancers such as hepatocellular carcinoma, liver transplant improves 5-year overall survival in carefully selected patients1. For CC, however, the benefit of replacing the cancerous heart is uncertain because one-year survival is generally estimated around 50% after this rare operation.
Studies have shown that highly selected patients undergoing combined heart-kidney (HK) and heart-liver transplants (HLv) have short- and long-term outcomes comparable to those observed in primary heart transplantation (HT). Adults patients with stage D heart failure that underwent combined HK, HLv and heart-lung (HL) were identified in the United Network for Organ Sharing (UNOS) registry between 1991 and 2016, with follow-up through March 2018. We conducted inverse probability of treatment weighting (IPTW) survival analysis of long-term survival stratified by type of combined organ transplant, accounting for donor, recipie...
This study examined the impact of TVP at time of LVAD implantation on clinical outcomes and quality of life metrics.
This study provides direct evidence for the contribution of gut microbiota to the cognitive decline during normal aging and suggests that restoring microbiota homeostasis in the elderly may improve cognitive function. On Nutraceutical Senolytics https://www.fightaging.org/archives/2020/05/on-nutraceutical-senolytics/ Nutraceuticals are compounds derived from foods, usually plants. In principle one can find useful therapies in the natural world, taking the approach of identifying interesting molecules and refining them to a greater potency than naturally occurs in order to produce a usefully large therape...
Mechanical Circulatory Support (MCS) has become a mainstay in the treatment of advanced heart failure refractory to medical therapy, either as bridge to heart transplantation or destination therapy. Two-year survival for destination therapy patients, historically below 20% on medical therapy alone (REMATCH - Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure)1, is now approaching 80%, similar to heart transplant, with the Food and Drug Administration-approved HeartMate 3 (HM3) LVAD2.
Our hospital system includes a central 825-bed, short term, acute care teaching facility where heart transplantation is performed under regulatory approval. Located 5.5 miles north of this main campus is a 107-bed cardiac specialty hospital which operates on a ‘single bed’ concept that allows patients to remain in the same bed throughout their hospital stay. All rooms allow for the entire spectrum of care, including hemodynamic monitoring, perioperative and intensive care, and complete cardiac and device management.
ConclusionsA clear trend towards worse outcome with larger TRV or TR% was shown; however, the number of events was insufficient for significant outcome differences. Prognostic value of quantitative TR should be investigated in a larger multicentre cohort. Effective RV ejection fraction may be considered an improved measure of RV function in PAH.
Conclusions. Diagnosis of constrictive pericarditis should be considered in patients with new-onset heart failure symptoms or recurrent pleural effusions within 2 years of lung transplantation. Idiopathic pulmonary fibrosis may be associated with increased risk for constrictive pericarditis. Pericardiectomy is a safe and effective treatment for posttransplant constrictive pericarditis.
Adverse events, and in particular strokes, during continuous flow durable left ventricular assist devices (LVAD) remain the major barrier to greater application among patients with ambulatory advanced heart failure.
Durable and temporary mechanical circulatory support (MCS) device support provides life-saving benefit for patients with advanced heart failure but is associated with major adverse events. The accurate categorization and documentation of adverse events associated with MCS device therapy has long been recognized as an essential requirement to adequately assess patient outcomes, inform patient decision making, provide critical feedback to advance patient management practices, and improve device technology.