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Demystifying Volume Status: An Ultrasound-Guided Physiologic Framework.
Chest
January 2025
Department of Medicine, University of British Columbia. Electronic address:
Topic Importance: Accurate assessment of a patient's volume status is crucial in many conditions, informing decisions on fluid prescribing, vasoactive agents, and decongestive therapies. Determining a patient's volume status is challenging, due to limitations in examination and investigations and the complexities of fluid homeostasis in disease states. Point-of-care ultrasound (POCUS) is useful in assessing hemodynamic parameters related to volume status, fluid responsiveness, and fluid tolerance.
View Article and Find Full Text PDFA predictive model for depression risk in individuals with hypertension: evidence from NHANES 2007-2020.
BMC Public Health
January 2025
Meizhou Hospital of Guangzhou University of Chinese Medicine, Meizhou, Guangdong, China.
Objective: Hypertension increases the prevalence of depression to a certain extent and identification and diagnosis of depression frequently pose challenges for clinicians. The study aimed to construct and validate a scoring model predicting the prevalence of depression with hypertension.
Methods: 6124 individuals with hypertension were utilized from the 2007 to 2020 National Health and Nutrition Examination Survey database (NHANES), including 645 subjects that were assessed to have depressive symptoms, 390 in the development group and 255 in the validation group.
Cardio-Renal Syndrome: Latest Developments in Device-Based Therapy.
J Clin Med
December 2024
Second Department of Internal Medicine, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Cardio-renal syndrome (CRS) is a complex condition involving bidirectional dysfunction of the heart and kidneys, in which the failure of one organ exacerbates failure in the other. Traditional pharmacologic treatments are often insufficient to manage the hemodynamic and neurohormonal abnormalities underlying CRS, especially in cases resistant to standard therapies. Device-based therapies have emerged as a promising adjunct or alternative approach, offering targeted intervention to relieve congestion, improve renal perfusion, and modulate hemodynamics.
View Article and Find Full Text PDFTrajectory of Urine Parameters by Adding Herbal Kampo Medicine Goreisan to Tolvaptan in Patients with Congestive Heart Failure.
J Clin Med
December 2024
The Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.
Even in current guideline-directed medical therapy, including recently introduced vasopressin type 2 receptor antagonist tolvaptan, congestion has not been resolved in patients with heart failure. Kampo medicine goreisan has been receiving considerable attention as an additional therapy for patients who are refractory to conventional diuretics therapy, including tolvaptan. However, the impact of goreisan on urine electrolytes remains uncertain.
View Article and Find Full Text PDFPropensity Score Analysis of Possible Medication Effects on Outcomes in Patients With Systemic Right Ventricles.
JACC Adv
January 2025
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.
Background: Patients with systemic right ventricle (SRV), either d-transposition of the great arteries following an atrial switch procedure or congenitally corrected transposition of the great arteries, develop severe right ventricular dysfunction, prompting appropriate medical therapy. However, the efficacy of beta-blockers and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors (ACEI) in SRV patients is unproven.
Objectives: The objective of this study was to determine the effects of ACEI/ARB and beta-blockers on outcomes in SRV patients after accounting for likely cofounders affecting their use.
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