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Embase <1980 to 2014 Week 13>
Embase (updates since 2014-03-21)
<1>
Accession Number
2014189405
Authors
Tian T. Chen B. Xiao Y. Yang K. Zhou X.
Institution
(Tian, Chen, Xiao, Yang, Zhou) Department of Cardiology, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking
Union Medical College, No. 167, Beilishi Road, Beijing 100037, China
Title
Intramyocardial autologous bone marrow cell transplantation for ischemic
heart disease: A systematic review and meta-analysis of randomized
controlled trials.
Source
Atherosclerosis. 233 (2) (pp 485-492), 2014. Date of Publication: April
2014.
Publisher
Elsevier Ireland Ltd
Abstract
Objective: This study was undertaken to evaluate the efficacy of
intramyocardial bone marrow cell (BMC) transplant therapy for ischemic
heart disease (IHD). Methods: The PubMed, Embase, and Cochrane Library
databases through October 2013 were searched for randomized clinical
trials (RCTs) of intramyocardial BMCs to treat IHD. The primary endpoint
was change in left ventricular ejection fraction (LVEF). Secondary
endpoints were changes in left ventricular end-systolic volume (LVESV) and
left ventricular end-diastolic volume (LVEDV). Weighted mean differences
for the changes were estimated with a random-effects model. Results:
Eleven RCTs with 492 participants were included. Intramyocardial BMC
transplantation increased LVEF (4.91%; 95% confidence interval [CI]
2.84%-6.99%; P<0.00001), reduced LVESV (10.66mL; 95% CI,-18.92mL
to-2.41mL; P=0.01), and showed a trend toward decreased LVEDV (-7.82mL;
95% CI,-16.36mL-0.71mL; P=0.07). Patients suitable for revascularization
with coronary artery bypass grafting had greater improvement in LVEF
(7.60%; 95% CI, 4.74%-10.46%, P<0.00001) than those unsuitable for
revascularization (3.76%; 95% CI, 2.20%-5.32%; P<0.00001). LVEDV reduction
was also more significant in revascularizable IHD (-16.51mL; 95%
CI,-22.05mL to-10.07mL; P<0.00001) than non-revascularizable IHD (-0.89mL;
95% CI,-8.44mL-6.66mL; P=0.82). Conclusion: Intramyocardial BMC injection
contributes to improvement in left ventricular dysfunction and reduction
in left ventricular volume. Patients with revascularizable IHD may benefit
more from this therapy. 2014 Elsevier Ireland Ltd.
<2>
Accession Number
2014175076
Authors
Shao X. Tian L. Xu W. Zhang Z. Wang C. Qi C. Ni Z. Mou S.
Institution
(Shao, Tian, Xu, Zhang, Wang, Qi, Ni, Mou) Department of Nephrology,
Shanghai Jiao Tong University, Ren Ji Hospital, Shanghai, China
Title
Diagnostic value of urinary kidney injury molecule 1 for acute kidney
injury: A meta-analysis.
Source
PLoS ONE. 9 (1) , 2014. Article Number: e84131. Date of Publication: 03
Jan 2014.
Publisher
Public Library of Science
Abstract
Background: Urinary Kidney Injury Molecule 1 (KIM-1) is a proximal tubular
injury biomarker for early detection of acute kidney injury (AKI), with
variable performance characteristics depending on clinical and population
settings. Methods: Meta-analysis was performed to assess the diagnostic
value of urinary KIM-1 in AKI. Relevant studies were searched from
MEDLINE, EMBASE, Pubmed, Elsevier Science Direct, Scopus, Web of Science,
Google Scholar and Cochrane Library. Meta-analysis methods were used to
pool sensitivity and specificity and to construct summary receiver
operating characteristic (SROC) curves. Results: A total of 2979 patients
from 11 eligible studies were enrolled in the analysis. Five prospective
cohorts, two crosssectional and four case-control studies were identified
for meta-analysis. The estimated sensitivity of urinary KIM-1 for the
diagnosis of AKI was 74.0% (95% CI, 61.0%-84.0%), and specificity was
86.0% (95% CI, 74.0%-93.0%). The SROC analysis showed an area under the
curve of 0.86(0.83-0.89). Subgroup analysis suggested that population
settings and detection time were the key factors affecting the efficiency
of KIM-1 for AKI diagnosis. Limitation: Various population settings,
different definition of AKI and Serum creatinine level used as the
standard might have influence on AKI diagnosis. The relatively small
number of studies and heterogeneity between them also affected the
evaluation. Conclusion: Urinary KIM-1 may be a promising biomarker for
early detection of AKI with considerable predictive value, especially for
cardiac surgery patients, and its potential value needs to be validated in
large studies and across a broader scope of clinical settings. 2014 Shao
et al.
<3>
Accession Number
2014178071
Authors
Jacob K.A. Nathoe H.M. Dieleman J.M. Van Osch D. Kluin J. van Dijk D.
Institution
(Jacob, Kluin) Department of Cardiothoracic Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Jacob, Nathoe, Van Osch) Department of Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
(Jacob, Dieleman, van Dijk) Department of Anesthesiology and Intensive
Care, University Medical Center Utrecht, Utrecht, Netherlands
Title
Inflammation in new-onset atrial fibrillation after cardiac surgery: A
systematic review.
Source
European Journal of Clinical Investigation. 44 (4) (pp 402-428), 2014.
Date of Publication: April 2014.
Publisher
Blackwell Publishing Ltd
Abstract
Background: Postoperative new-onset atrial fibrillation (PNAF) is the most
common complication following cardiac surgery. The pathogenesis of PNAF is
multifactorial. The concept of the postoperative inflammatory response, as
a potential underlying mechanism has been extensively studied. This review
aims to provide a comprehensive summary of literature relevant to the
association between the inflammatory response following cardiac surgery
and PNAF. Design: MEDLINE, EMBASE and the Cochrane Central Register were
systematically reviewed by two independent investigators for studies
published between January 1980 and May 2012, in which an association
between serum markers of inflammation and PNAF was evaluated, or the
effect of drugs with anti-inflammatory properties on the risk of PNAF.
Results: Sixty-three studies met selection criteria (39 observational and
24 randomized studies) including 27 363 patients. The mean incidence of
PNAF after cardiac surgery was 255%. Elevated levels of various
inflammatory mediators were associated with PNAF, and the most consistent
association was found between white blood cell count and PNAF. Of the
drugs with anti-inflammatory properties, statins gave the best protective
effect against PNAF, followed by anti-oxidants, steroids and colchicine.
Nonsteroidal anti-inflammatory drugs did not prevent PNAF significantly.
Conclusion: The postoperative inflammation response may play a role in the
pathogenesis of PNAF. However, of the inflammation biomarkers, only
elevated white blood cell count reliably predicts PNAF. Pre- and
perioperative use of statins and several other drugs with
anti-inflammatory properties reduce the incidence of PNAF. 2014 Stichting
European Society for Clinical Investigation Journal Foundation.
<4>
Accession Number
2014162295
Authors
Sun Y. Liu X. Guo L. Pang W. Guo X. Sun Z. Li Z. Cui X. Li H. Tao G. Wang
L. Zhou C. Liu Y. Shan H. Wang M. Liu M. Li J. Yin L. Hu D.
Institution
(Sun, Guo, Guo) Department of Cardiology, First Hospital of China Medical
University, 155 Nanjing North Street, Heping District, Shenyang 110001,
China
(Liu, Pang, Sun) Department of Cardiology, Shengjing Hospital of China
Medical University, Shenyang, China
(Li, Liu) Department of Cardiology, Liaoning Provincial Hospital,
Shenyang, China
(Cui, Shan) Department of Cardiology, Affiliated Hospital of Inner
Mongolia University, Hohhot, China
(Li, Wang) Department of Cardiology, General Hospital of Daqing Oil Field,
Daqing, China
(Tao, Liu) Department of Cardiology, Affiliated Hospital of Liaoning
Medical College, Jinzhou, China
(Wang, Li) Department of Cardiology, First Affiliated Hospital of Harbin
Medical University, Harbin, China
(Zhou, Yin) Department of Cardiology, Affiliated Hospital of Qingdao
University School of Medicine, Qingdao, China
(Hu) Heart Center, Peking University People's Hospital, Beijing, China
Title
HTUPA as a new thrombolytic agent for acute myocardial infarction: A
multicenter, randomized study.
Source
International Journal of Cardiology. 172 (2) (pp 326-331), 2014. Date of
Publication: 15 Mar 2014.
Publisher
Elsevier Ireland Ltd
Abstract
Background It is necessary to develop a new thrombolytic agent which can
be used by a single bolus at first aid sites to decrease the time to
reperfusion in clinical practice. HTUPA, a genetically engineered new
thrombolytic with a longer half-life, is well qualified. We aim to compare
the thrombolytic efficacy and safety of human tissue urokinase type
plasminogen activator (HTUPA) to recombinant tissue plasminogen activator
(rt-PA) in Chinese patients with acute myocardial infarction (AMI).
Methods AMI patients (n = 221) were randomized to rt-PA (a standard
protocol) or HTUPA (25 mg bolus) treatment groups. All patients also
received oral aspirin and intravenous heparin. Coronary angiography was
performed 90 min after therapy initiation to determine infarct-related
coronary artery (IRA) patency. Clinical outcomes and changes of clotting
variables, heart rate, blood pressure, left ventricular ejection fraction
(LVEF), and electrocardiogram were evaluated. Results Patent IRA
[thrombolysis in myocardial infarction (TIMI) grade 2 or 3] was observed
in 77% of HTUPA-treated patients, compared to 76% of rt-PA-treated
patients (P = 0.76). TIMI grade 3 patency rates were 52% and 44% in the
HTUPA and rt-PA groups, respectively (P = 0.37). The total patency rate
was 77% (86/111 patients) in the HTUPA group and 73% (80/110 patients) in
the rt-PA group (P = 0.41). Adverse events were infrequent in both groups,
and no significant differences were detected in mortality, re-occlusion
rate, revascularization rate, adverse effects, clotting index, LVEF, or
electrocardiogram between the two groups. Conclusions Intravenous HTUPA
had a safe and efficacious profile as good as rt-PA in patients with AMI.
2014 Elsevier Ireland Ltd.
<5>
Accession Number
2014162302
Authors
Garcia D.C. Benjo A. Cardoso R.N. Macedo F.Y.B. Chavez P. Aziz E.F. Herzog
E. Alam M. De Marchena E.
Institution
(Garcia, Cardoso, De Marchena) Department of Internal Medicine/Cardiology,
University of Miami/Jackson Memorial Hospital, Miami, FL, United States
(Benjo) Department of Cardiology, Ochsner Medical Center, New Orleans, LA,
United States
(Macedo, Alam) Department of Cardiology, Baylor College of Medicine,
Houston, TX, United States
(Chavez, Aziz, Herzog) Department of Cardiology, Columbia College of
Physicians and Surgeons, St. Luke's Hospital, New York, NY, United States
Title
Device stratified comparison among transfemoral, transapical and
transubclavian access for Transcatheter Aortic Valve Replacement (TAVR): A
meta-analysis.
Source
International Journal of Cardiology. 172 (2) (pp e318-e321), 2014. Date of
Publication: 15 Mar 2014.
Publisher
Elsevier Ireland Ltd
<6>
Accession Number
2014160481
Authors
Gaeini A.A. Satarifard S. Heidary A.
Institution
(Gaeini, Satarifard, Heidary) Department of Exercise Physiology, School of
Physical Education, University of Tehran, Tehran, Iran, Islamic Republic
of
Title
Comparing the effect of eight weeks of high-intensity interval training
and moderate-intensity continuous training on physiological variables of
exercise stress test in cardiac patient after coronary artery bypass
graft.
Source
Journal of Isfahan Medical School. 31 (267) (pp 2171-2181), 2014. Date of
Publication: March 2014.
Publisher
Isfahan University of Medical Sciences(IUMS) (Hezar Jerib Avenue, P.O. Box
81745-319, Isfahan, Iran, Islamic Republic of)
Abstract
Background: Cardiac rehabilitation improves functional capacity in cardiac
patients after coronary artery bypass. The aim of this study was to
compare the eight weeks of interval training with continuous training on
stress test physiological variables in patient with cardiac diseases after
coronary artery bypass graft (CABG) surgery. Methods: In this clinical
trial study, 30 patient with cardiac diseases in Tehran Heart Center
(Iran) having had CABG surgery were randomly divided into two groups,
high-intensity interval and continuous moderate-intensity training
(program common). The program of interval group was included 4 repeats x 4
minutes at 90-95% peak of heart rate (HR) and continuous group, 60-80
minute at 70-85% peak HR, three sessions per week for 8 weeks. Functional
capacity (VO2 peak), distance traveled, time to exhaustion and maximum
heart rate (HRmax) were assessed during the Bruce exercise stress test
before and after the training program. The collected data were analyzed
using the one-way analysis of variances (ANOVA) and post hoc Fisher's
least significant difference (LSD) tests. Findings: Functional capacity
was increased significantly following the both of training programs with
no significant difference between the two groups (P < 0.05). The increases
in traveled distance, time to exhaustion, and HRmax after interval program
were more in interval program group (P < 0.05). Conclusion: It seems that
both high-intensity interval and moderate-intensity continuous training
improve functional capacity in cardiac patient with cardiac diseases after
coronary artery bypass sugery. However, interval training was more
beneficial than continuous training in some parameters such as traveled
distance, time to exhaustion, and HRmax during exercise stress test.
<7>
Accession Number
2014174212
Authors
Kwiatkowski M. Welch P. McComb J. Shepler B.
Institution
(Kwiatkowski, Welch, Shepler) Purdue University College of Pharmacy, 575
Stadium Mall Drive, West Lafayette, IN 47907-2091, United States
(McComb) Lutheran Hospital, Fort Wayne, IN, United States
Title
Evaluating the use of bortezomib and eculizumab in desensitization of
transplant patients.
Source
Journal of Pharmacy Technology. 30 (1) (pp 31-38), 2014. Date of
Publication: February 2014.
Publisher
Harvey Whitney Books Company
Abstract
Objective: To systematically review the existing literature concerning the
utilization of bortezomib and eculizumab to determine if there is enough
evidence to warrant their routine use in desensitization protocols for
high-risk transplant candidates. Data Sources: PubMed, Google Scholar, and
ClinicalTrials.gov were searched using the terms bortezomib, eculizumab,
desensitization, transplant, highly-sensitized, pre-sensitized, and
antibody-mediated rejection (AMR). The articles included were published
between January 2009 and August 2012. Study Selection and Data Extraction:
All English-language articles involving human subjects were assessed for
inclusion. The search included articles evaluating the use of these agents
in desensitization and the prevention of AMR, but excluded articles
investigating these drugs in the treatment of established AMR. Data
Synthesis: Highly sensitized transplant candidates are at an increased
risk of developing AMR after transplant; desensitization potentially
reduces this risk. The addition of bortezomib and eculizumab to current
desensitization protocols may enhance outcomes. The bortezomib search
produced 3 efficacy trials, 1 safety trial, 2 in-progress trials, 14
patient cases from 8 published case reports, and 3 efficacy study
abstracts. Conclusions: Much of the available literature assessing the
efficacy of bortezomib and eculizumab for use in desensitization exists as
restricted clinical trials and incomplete case reports. Bortezomib and
eculizumab appear to be potentially effective additions to current
desensitization protocols. However, we are unable to determine at this
time whether these agents improve the most clinically relevant outcome of
successful transplantation. Further well-designed clinical trials are
needed to determine their true clinical efficacy in highly sensitized
transplant candidates. The Author(s) 2013.
<8>
[Use Link to view the full text]
Accession Number
2014176617
Authors
Tomai F. Ribichini F. De Luca L. Petrolini A. Ghini A.S. Weltert L.
Spaccarotella C. Proietti I. Trani C. Nudi F. Pighi M. Vassanelli C.
Institution
(Tomai, De Luca, Petrolini, Ghini, Weltert) Department of Cardiovascular
Sciences, Division of Cardiology, European Hospital, Via Portuense 700,
00149 Rome, Italy
(Ribichini, Pighi, Vassanelli) Division of Cardiology of the Department of
Medicine, University of Verona, Verona, Italy
(Spaccarotella) Institute of Cardiology, University Magna Grecia,
Catanzaro, Italy
(Proietti) Department of Cardiology, Vannini Hospital, Rome, Italy
(Trani) Institute of Cardiology, Cattolica University, Rome, Italy
(Nudi) Division of Nuclear Medicine, Madonna della Fiducia Clinic, Rome,
Italy
Title
Randomized comparison of xience v and multi-link vision coronary stents in
the same multivessel patient with chronic kidney disease (RENAL-DES)
study.
Source
Circulation. 129 (10) (pp 1104-1112), 2014. Date of Publication: 11 Mar
2014.
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND - : Percutaneous coronary interventions in patients with
chronic kidney disease have shown suboptimal results. Drug-eluting stents
(DES) might reduce the rate of target vessel revascularization in
comparison with bare-metal stents (BMS) in patients with chronic kidney
disease. However, given the multiple concomitant individual variables
present in such patients, the comparison of neointimal growth after
percutaneous coronary intervention is complex and difficult to assess.
METHODS AND RESULTS - : Randomized Comparison of Xience V and Multi-Link
Vision Coronary Stents in the Same Multivessel Patient with Chronic Kidney
Disease (RENAL-DES) was a prospective, randomized, multicenter study to
directly compare the efficacy in the prevention of clinical restenosis of
everolimus-eluting stent (Xience V) and BMS with an identical design
(Multi-Link Vision), both implanted in the same patient with multivessel
coronary artery disease and chronic kidney disease (estimated glomerular
filtration rate <60 mL/min). The primary end point of the study was the
ischemia-driven target vessel revascularization as detected with
myocardial scintigraphy at 12 months. In 215 patients, 512 coronary
vessels were successfully treated with the randomly assigned DES (n=257)
or BMS (n=255). At 1 year, the rate of ischemia-driven target vessel
revascularization for DES and BMS groups was 2.7% (95% confidence
interval, 1.1%-5.6%) and 11.4% (95% confidence interval, 7.8% to 16%),
respectively, P<0.001. For the multivariate analysis, independent
predictors of the ischemia-driven target vessel revascularization were BMS
implantation (odds ratio, 4.95; 95% confidence interval, 2.1-11.6;
P<0.001) and vessel size (odds ratio, 0.32; 95% confidence interval,
0.1-0.7; P=0.006). CONCLUSIONS - : This is the first randomized trial
showing a reduction of clinical restenosis with a new-generation DES in
comparison with a BMS of equal design, in patients who have chronic kidney
disease with multivessel coronary artery disease. 2013 American Heart
Association, Inc.
<9>
Accession Number
2014174201
Authors
Wilby K.J. Harder C.K.
Institution
(Wilby, Harder) Department of Pharmacy, Royal Jubilee Hospital, 1952 Bay
Street, Victoria, BC, V8R 1J8, Canada
(Harder) Department of Pharmacy, Vancouver Island Health Authority,
Victoria, BC, Canada
Title
Nicotine replacement therapy in the intensive care unit: A systematic
review.
Source
Journal of Intensive Care Medicine. 29 (1) (pp 22-30), 2014. Date of
Publication: January-February 2014.
Publisher
SAGE Publications Inc.
Abstract
Objective: The objective of this review was to systematically review and
evaluate available literature describing the effect of nicotine
replacement therapy (NRT) on mortality and other outcomes in
nicotine-dependent critically ill patients admitted to the intensive care
unit (ICU). Data Sources: A systematic search of the following databases
was performed: MEDLINE (1948-August 2011), EMBASE (1980-August 2011),
Cochrane Database of Systematic Reviews, International Pharmaceutical
Abstracts (1970- August 2011), Google, and Google Scholar. Study
Selection: Studies that reported outcomes associated with any form of NRT
in any intensive care setting were included. Studies were included
regardless of design or number of participants reported. Studies published
in languages other than English were excluded. Data Extraction: Data from
each study were extracted using a standardized data extraction tool.
Information included the study design, number of patients, classification
of ICU, baseline characteristics, outcomes assessed, and overall results.
Data Synthesis: Our search identified 8 studies, of which 7 met the
inclusion criteria. These 7 studies were qualitatively reviewed and
critically appraised for methodological quality, robustness of results,
and internal and external validity. The results of similar studies and
populations were compared in order to draw conclusions pertaining to
specific intensive care settings. Conclusions: We conclude that NRT should
not be routinely prescribed to patients admitted to intensive care
settings. With only equivocal evidence of efficacy and signals suggesting
increased toxicity, we believe that its use should be limited to selected
patients where the potential benefit clearly outweighs the risk. There is
a need for adequately powered randomized controlled trials to confirm the
benefits and risks of NRT in the ICU overall but also in its unique
subpopulations. The Author(s) 2012.
<10>
Accession Number
2014173483
Authors
Conway A. Schadewaldt V. Clark R. Ski C. Thompson D.R. Kynoch K. Doering
L.
Institution
(Conway) School of Nursing, Institute of Health and Biomedical Innovation,
Queensland University Technology, Kelvin Grove, QLD 4059, Australia
(Schadewaldt) Faculty of Health Sciences, Australian Catholic University,
Australia
(Clark) School of Nursing, Midwifery Flinders University, Australia
(Ski, Thompson) Cardiovascular Research Centre, Australian Catholic
University, Australia
(Kynoch) Queensland Centre for Evidence Based Nursing and Midwifery, Mater
Health Services, Australia
(Doering) School of Nursing, University of California Los Angeles, United
States
Title
The effectiveness of non-pharmacological interventions in improving
psychological outcomes for heart transplant recipients: A systematic
review.
Source
European Journal of Cardiovascular Nursing. 13 (2) (pp 108-115), 2014.
Date of Publication: April 2014.
Publisher
Elsevier
Abstract
Background: Post-heart transplant psychological distress may directly
hinder physiological health as well as indirectly impact on clinical
outcomes by increasing unhealthy behaviors, such as immunosuppression
non-adherence. Reducing psychological distress for heart transplant
recipients is therefore vitally important in order to improve not only
patients overall health and well-being but also clinical outcomes, such as
morbidity and mortality. Evidence from other populations suggests that
non-pharmacological interventions may be an effective strategy. Aim: The
purpose of this study was to appraise the efficacy of non-pharmacological
interventions on psychological outcomes after heart transplant. Method: A
systematic review was conducted using the Joanna Briggs Institute
methodology. Experimental and quasiexperimental studies that involved any
non-pharmacological intervention for heart transplant recipients were
included, provided that data on psychological outcomes were reported.
Multiple electronic databases were searched for published and unpublished
studies and reference lists of retrieved studies were scrutinized for
further primary research. Data were extracted using a standardized data
extraction tool. Included studies were assessed by two independent
reviewers using standardized critical appraisal instruments. Results:
Three studies fulfilled the inclusion and exclusion criteria, which
involved only 125 heart transplant recipients. Two studies reported on
exercise programs. One study reported a web-based psychosocial
intervention. While psychological outcomes significantly improved from
baseline to follow-up for the recipients who received the interventions,
betweengroup comparisons were not reported. The methodological quality of
the studies was judged to be poor. Conclusions: Further research is
required, as we found there is insufficient evidence available to draw
conclusions for or against the use of non-pharmacological interventions
after heart transplant. The European Society of Cardiology 2013.
<11>
Accession Number
2014162950
Authors
Makkar R.R. Jilaihawi H. Mack M. Chakravarty T. Cohen D.J. Cheng W.
Fontana G.P. Bavaria J.E. Thourani V.H. Herrmann H.C. Pichard A. Kapadia
S. Babaliaros V. Whisenant B.K. Kodali S.K. Williams M. Trento A. Smith
C.R. Teirstein P.S. Cohen M.G. Xu K. Tuzcu E.M. Webb J.G. Leon M.B.
Institution
(Makkar, Jilaihawi, Chakravarty, Cheng, Trento) Cedars-Sinai Heart
Institute, Advanced Health Sciences Pavillion, 127 S. San Vicente
Boulevard, Los Angeles, CA 90048, United States
(Mack) Baylor Health Care System, Plano, TX, United States
(Cohen) Saint-Luke's Mid America Heart Institute, Kansas City, MO, United
States
(Fontana) Lenox Hill Heart and Vascular Institute, New York, NY, United
States
(Bavaria, Herrmann) Hospital of the University of Pennsylvania,
Philadelphia, PA, United States
(Thourani, Babaliaros) Emory University, Atlanta, GA, United States
(Pichard, Tuzcu) Washington Hospital Center, Washington, DC, United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kodali, Williams, Smith, Xu, Leon) Herbert and Sandi Feinberg
Interventional Cardiology, Heart Valve at Columbia University Medical
Center, New York-Presbyterian Hospital, New York, NY, United States
(Teirstein) Scripps Clinic and Scripps Translational Science Institute,
San Diego, CA, United States
(Cohen) University of Miami Miller School of Medicine, Miami, FL, United
States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
Title
Stratification of outcomes after transcatheter aortic valve replacement
according to surgical inoperability for technical versus clinical reasons.
Source
Journal of the American College of Cardiology. 63 (9) (pp 901-911), 2014.
Date of Publication: 11 Mar 2014.
Publisher
Elsevier USA
Abstract
Objectives The goal of this study was to examine the impact of reasons for
surgical inoperability on outcomes in patients undergoing transcatheter
aortic valve replacement (TAVR). Background Patients with severe aortic
stenosis may be deemed inoperable due to technical or clinical reasons.
The relative impact of each designation on early and late outcomes after
TAVR is unclear. Methods Patients were studied from the inoperable arm
(cohort B) of the randomized PARTNER (Placement of Aortic Transcatheter
Valve) trial and the nonrandomized continued access registry. Patients
were classified according to whether they were classified as technically
inoperable (TI) or clinically inoperable (CLI). Reasons for TI included
porcelain aorta, previous mediastinal radiation, chest wall deformity, and
potential for injury to previous bypass graft on sternal re-entry. Reasons
for CLI were systemic factors that were deemed to make survival unlikely.
Results Of the 369 patients, 23.0% were considered inoperable for
technical reasons alone; the remaining were judged to be CLI. For TI, the
most common cause was a porcelain aorta (42%); for CLI, it was multiple
comorbidities (48%) and frailty (31%). Quality of life and 2-year
mortality were significantly better among TI patients compared with CLI
patients (mortality 23.3% vs. 43.8%; p < 0.001). Nonetheless, TAVR led to
substantial survival benefits compared with standard therapy in both
inoperable cohorts. Conclusions Patients undergoing TAVR based solely on
TI have better survival and quality of life improvements than those who
are inoperable due to clinical comorbidities. Both TI and CLI TAVR have
significant survival benefit in the context of standard therapy. (THE
PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial;
NCT00530894).
<12>
[Use Link to view the full text]
Accession Number
2014176695
Authors
Slagsvold K.H. Rognmo O. Hoydal M. Wisloff U. Wahba A.
Institution
(Slagsvold, Rognmo, Hoydal, Wisloff, Wahba) K.G. Jebsen Center of Exercise
in Medicine, Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, PO box 8905, 7491 Trondheim, Norway
(Slagsvold, Wahba) Department of Cardiothoracic Surgery, St. Olav's
Hospital, Trondheim University Hospital, Trondheim, Norway
Title
Remote ischemic preconditioning preserves mitochondrial function and
influences myocardial MicroRNA expression in atrial myocardium during
coronary bypass surgery.
Source
Circulation Research. 114 (5) (pp 851-859), 2014. Date of Publication: 28
Feb 2014.
Publisher
Lippincott Williams and Wilkins
Abstract
RATIONALE:: Remote ischemic preconditioning (RIPC) has been suggested to
induce cardioprotection during cardiac surgery. Maintaining proper atrial
function is imperative in preventing arrhythmia and thrombus formation.
Mitochondria have been proposed as key targets in conveying RIPC
mechanisms and effects. MicroRNA (miR) is emerging as an important
regulator of mitochondrial function, arrhythmia, and protection from
ischemia and reperfusion. OBJECTIVE:: This study aimed to evaluate the
effect of RIPC on mitochondrial respiration and miR expression in human
atrial tissue. METHODS AND RESULTS:: Sixty patients undergoing coronary
artery bypass graft surgery were randomized to RIPC (n=30) or control
(n=30). RIPC was performed preoperatively by inflating a blood pressure
cuff on the upper arm to 200 mm Hg for 3x5 minutes, with 5 minutes
reperfusion intervals. Biopsies were obtained from the right atrial
appendage before and after aortic cross-clamping. Mitochondrial
respiration was measured in situ and miR assessed by commercial miR array
and quantitative reverse transcription polymerase chain reaction.
Postoperative atrial fibrillation occurrence was monitored by
biotelemetry. Maximal mitochondrial respiration was preserved throughout
surgery after RIPC but significantly reduced (-28%; P<0.05) after aortic
cross-clamping in control. Incidence of postoperative atrial fibrillation
was lower after RIPC versus control (14% versus 50%; P<0.01). Myocardial
expression of miR-133a and miR-133b increased after aortic cross-clamping
in both RIPC and control, whereas miR-1 was upregulated in control only.
MiR-338-3p expression was higher in RIPC versus control after aortic
cross-clamping. CONCLUSIONS:: RIPC preserves mitochondrial respiration and
prevents upregulation of miR-1 in the right atrium during coronary artery
bypass graft. 2014 American Heart Association, Inc.
<13>
Accession Number
71378547
Title
11th Annual ASRA Pain Medicine Meeting.
Source
Regional Anesthesia and Pain Medicine. Conference: 11th Annual ASRA Pain
Medicine Meeting Miami, FL United States. Conference Start: 20121115
Conference End: 20121118. Conference Publication: (var.pagings). 38 (1) ,
2013. Date of Publication: January-February 2013.
Publisher
Lippincott Williams and Wilkins
Abstract
The proceedings contain 138 papers. The topics discussed include: Bayesian
responder meta-analysis of regional anesthesia to prevent chronic pain
after iliac crest bone graft harvesting; comparison of analgesic
effectiveness of combined intraperitoneal instillation and periportal
infiltration of bupivacaine with intraperitoneal instillation or
periportal infiltration alone after laparoscopic cholecystectomy; the
effect of outpatient ketamine infusions on patient hemodynamics, level of
sedation and pain; nitrous oxide added at the end of anesthesia decreases
early postoperative pain; comparison of three blocks regimens for
postoperative analgesia in ambulatory shoulder surgery: a double-blinded
prospective randomised pilot study; incidence of new chronic pain higher
following thoracotomy when compared to video assisted thoracic surgery;
and efficacy and safety of tanezumab versus placebo and oxycodone in
adults with hip or knee osteoarthritis pain (NCT00985621).
<14>
Accession Number
71377452
Authors
Didsbury M. Mcgee R.G. Tong A. Craig J.C. Wong G.
Institution
(Didsbury, Mcgee, Tong, Craig, Wong) Sydney School of Public Health,
University of Sydney, NSW 2006, Australia
(Mcgee, Tong, Craig) Centre for Kidney Research, Children's Hospital at
Westmead, Westmead, NSW 2145, Australia
(Wong) Centre for Transplant and Renal Research, Westmead Hospital,
Westmead, NSW 2145, Australia
Title
Exercise training in solid organ transplant recipients-a systematic
review.
Source
Nephrology. Conference: 48th Annual Scientific Meeting of the Australian
and New Zealand Society of Nephrology, ANZSN 2012 Auckland New Zealand.
Conference Start: 20120827 Conference End: 20120829. Conference
Publication: (var.pagings). 17 (pp 82-83), 2012. Date of Publication:
August 2012.
Publisher
Blackwell Publishing
Abstract
Aim: To assess the health benefits and harms of supervised exercise
training programs in solid organ transplant recipients. Background: Loss
of exercise capacity, reduction in bone mineral density and excessive
weight gain are common after solid organ transplantation. The health
benefits of exercise are well established in the general population but
unclear in patients with solid organ transplants. Methods: We
systematically reviewed all randomized controlled trials comparing the
outcomes of exercise training programs in solid organ recipients against
standard care. MEDLINE, Embase and the Cochrane Central Register of
Controlled Trials were searched to November 2011. A total of 585 patients
from thirteen RCTs (eight cardiac [227 patients]; two kidney [166
patients]; two lung [76 patients] and one liver transplant [119 patients])
were included in the analysis. Results: Compared with standard care,
cardiac transplant recipients who engaged in an exercise training program
showed significant improvement in maximal oxygen uptake (VO2peak) (+2.79
mL/min/kg, CI: 0.74-4.83, P = 0.008). Single studies showed no significant
improvement in VO2peak in kidney recipients (+3.60 mL/min/kg, CI:
-0.22-7.42, P = 0.06), lung recipients (-1.80 mL/min/kg, CI: -4.49-0.89, P
= 0.19) or liver recipients (+1.60 mL/min/ kg, CI: -1.13-4.33, P = 0.25).
There was also no significant improvement in the overall serum lipid
profile, body morphology, blood pressure and glycaemic control between
exercise training and standard care in kidney, lung and cardiac transplant
recipients. Conclusions: Based on current evidence, the benefits of
exercise training in solid organ recipients are limited to improved
functional capacity. There was insufficient data to conclude any effect on
cardiovascular risk factors such as hypertension and diabetes. Future
trials should focus on the long-term effects of various types of exercise
training on patient-relevant outcomes such as cardiovascular related
events and mortality.
<15>
Accession Number
71371560
Authors
Banque M.N.F.
Institution
(Banque) Division of Pulmonary and Critical Care Medicine, Section of
Pediatric Pulmonology, Philippine Heart Center, Quezon City, Philippines
Title
Rudhe syndrome: Reversible shunt related lobar emphysema-a report of cases
and systematic review of literature.
Source
Respirology. Conference: 18th Congress of the Asian Pacific Society of
Respirology Yokohama Japan. Conference Start: 20131111 Conference End:
20131114. Conference Publication: (var.pagings). 18 (pp 60), 2013. Date
of Publication: November 2013.
Publisher
Blackwell Publishing
Abstract
Rudhe syndrome was used to refer to reversible shunt related lobar
emphysema (LE). Ulf Rudhe who made his first observation in 1971 that
emphysema in children with congenital heart disease is secondary to the
shunt thus surgical intervention be directed to the correction of the
cardiac defect alone and not lobectomy. We reviewed the cases of four
patients with concomitant LE and CHD. The medical records were evaluated
with reference to age, type of CHD, pulmonary function, radiographic
findings, pulmonary artery pressure, clinical signs and symptoms, surgical
management and outcome after surgery. We also reviewed 21 literatures on
LE with CHD. Among the four cases we had, 3 were left to right shunts and
1 is a case of Tetralogy of Fallot (TOF) with an absent pulmonary valve.
The 3 underwent correction of the cardiac lesion and repeat chest
radiograph and CT scan showed almost complete resolution of the lobar
emphysema with complete resolution of clinical symptoms 6 months post
cardiac surgery. The other one underwent TOF correction with lung tacking
with radiographic resolution of the lobar emphysema however patient
succumbed to sepsis. The most commonly affected lobes were the left upper
and right middle lobes. The literature review consisted of 137 subjects
with lobar emphysema with concomitant congenital heart disease. The three
most common cardiac lesions associated with lobar emphysema are
ventricular septal defect, patent ductus arterioles and TOF with absent
pulmonary valve. One hundred out of the 137 underwent correction of the
cardiac lesion without lobectomy. Resolution of airway obstruction as well
as radiographic resolution of the emphysematous lung were noted as early
as 3 months to 1 year post cardiac surgery. Earlier correction of cardiac
lesion improves the prognosis in terms of reversibility of lobar emphysema
and anatomic defects of the bronchus.
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