2,525 results match your criteria: "Advanced Heart Failure and Transplant Cardiology; Ascension St Vincent Hospital Indianapolis[Affiliation]"

Article Synopsis
  • Rheumatic and congenital heart diseases, along with cardiomyopathies and hypertensive heart disease, lead to significant health issues and fatalities in low- and lower middle-income countries (LLMICs), impacting the poorest populations.
  • Access to advanced cardiac care is limited, primarily concentrated in urban areas, creating a gap in healthcare for rural communities due to shortages of diagnostics, medications, and trained personnel.
  • The Package of Essential NCD Interventions - Plus (PEN-Plus) aims to improve access to cardiac care in these regions by decentralizing services, and a coalition of global cardiac organizations is collaborating to implement effective strategies for managing severe cardiac diseases in high-poverty settings.
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The role of oxidative/antioxidative system imbalances in advanced heart failure (HF) has not been fully investigated. The aim of this study was to identify factors associated with one-year mortality in patients with advanced HF, with particular emphasis on oxidative/antioxidative balance parameters. We analyzed 85 heart transplant candidates who were hospitalized at our institution for right heart catheterization.

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Thyroid Dysfunction in Advanced Heart Failure Patients and Its Correlation with Amiodarone Therapy: A Two-Year Study.

Biomedicines

March 2024

Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.

(1) Background: Advanced heart failure often accompanies ventricular arrhythmias, necessitating antiarrhythmic therapies. Amiodarone, commonly used for this purpose, may induce thyroid dysfunction due to its high iodine content. However, the prevalence and correlation of thyroid dysfunction with amiodarone in end-stage heart failure patients remain unclear.

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Background: Adults with congenital heart defects (ACHD) globally constitute a notably medically underserved patient population. Despite therapeutic advancements, these individuals often confront substantial physical and psychosocial residua or sequelae, requiring specialized, integrative cardiological care throughout their lifespan. Heart failure (HF) is a critical challenge in this population, markedly impacting morbidity and mortality.

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The first-generation Molecular Microscope (MMDx) system for heart transplant endomyocardial biopsies used expression of rejection-associated transcripts (RATs) to diagnose not only T cell-mediated rejection (TCMR) and antibody-mediated rejection (ABMR) but also acute injury. However, the ideal system should detect rejection without being influenced by injury, to permit analysis of the relationship between rejection and parenchymal injury. To achieve this, we developed a new rejection classification in an expanded cohort of 3230 biopsies: 1641 from INTERHEART (ClinicalTrials.

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CH-VAD left ventricular assist implantation combined with the Bentall procedure and coronary artery bypass grafting.

ESC Heart Fail

August 2024

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Street, Chaoyang District, Beijing, China.

Left ventricular assist device (LVAD) implantation is an effective alternative treatment to heart transplantation, especially for end-stage heart failure patients who are ineligible for or unable to await a heart transplant. This report describes a complex and innovative surgery where LVAD implantation was performed alongside multiple concomitant cardiac and aortic procedures. A 62-year-old male patient with complicated comorbidities developed acute myocardial infarction and subsequent refractory advanced heart failure.

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Background: The European Society of Cardiology (ESC) provided a focused update to the 2021 Guideline for the Management of Heart Failure, now providing a 1A recommendation for intravenous iron in patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency (ID). However, the findings from randomized controlled trials (RCT) are mixed. This systematic review of RCTs aims to provide an update and synthesize the evidence addressing the association of intravenous iron with patient-based outcomes in patients with HFrEF and ID.

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Hemodynamic derangements are defining features of cardiogenic shock. Randomized clinical trials have examined the efficacy of various therapeutic interventions, from percutaneous coronary intervention to inotropes and mechanical circulatory support (MCS). However, hemodynamic management in cardiogenic shock has not been well-studied.

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Article Synopsis
  • Patients with advanced heart failure may receive a left ventricular assist device (LVAD) to help manage their condition, but the risk of stroke is still a concern due to changes in blood flow dynamics once the device is implanted.
  • A study examined how the timing of a new pulsatility mode in the HeartMate 3 LVAD, which alters pump speed every two seconds, affects blood flow patterns that may contribute to blood clots.
  • Findings suggested that aligning the pulsatility mode with the heart's peak pumping phase reduces stagnant blood areas, potentially lowering the risk of thrombus formation and improving patient outcomes.
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Rates of Reproductive Counseling and Contraception Use in Patients with Heart Failure at a Tertiary Care Center.

J Card Fail

August 2024

Cardiology Division, Department of Medicine, 660 South Euclid Ave, Campus Box 8086, Washington University in St Louis, St Louis, Missouri. Electronic address:

Background: Increasing numbers of women of childbearing age have cardiac disease, including heart failure (HF). In these women, pregnancy can cause significant morbidity and mortality. Contraceptive use and pregnancy counseling in women with HF is an essential part of their medical care.

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Introduction: Chronic heart failure (HF) has high rates of mortality and hospitalization in patients with advanced chronic kidney disease (aCKD). However, randomized clinical trials have systematically excluded aCKD population. We have investigated current HF therapy in patients receiving clinical care in specialized aCKD units.

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Article Synopsis
  • Belatacept (BTC) is a fusion protein that inhibits T-cell activation and has primarily been used for immunosuppression in kidney transplants, but its effectiveness for heart transplant patients remains less understood.
  • A retrospective study analyzed 21 heart transplant recipients who received BTC between 2017 and 2021, focusing on their health outcomes, including rejection rates and kidney function over a follow-up period that extended to December 2023.
  • Results indicated that BTC treatment had a low rejection rate (4.8%) and stable graft function, with a slight improvement in kidney health for the majority of the patients, though a significant portion of them discontinued the treatment within the study period.
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Advanced hemodynamics for prognostication in heart failure: the pursuit of the patient-specific tipping point.

Front Cardiovasc Med

March 2024

Department of Medicine, Section of Cardiology, University of Chicago, Chicago, IL, United States.

Background: Objective tools to define the optimal time for referral for advanced therapies and to help guide escalation and de-escalation of support can improve management decisions and outcomes for patients with advanced heart failure. The current parameters have variable prognostic potential depending on the patient population being studied and often have arbitrary thresholds.

Methods: Here, a mathematical and physiological framework to define the patient-specific tipping point of myocardial energetics is defined.

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Aims: Increasing numbers of patients with advanced heart failure and significant comorbidity and social barriers are considered for left ventricular assist devices (LVADs). We sought to examine health care utilization post-LVAD implantation, including the influence of individual-level socio-economic position and multimorbidity.

Methods And Results: We conducted a Danish nationwide cohort study linking individual-level data from clinical LVAD databases, the Scandiatransplant Database, and Danish national medical and administrative registries.

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Advancements in Heart Transplantation: Donor-Derived Cell-Free DNA as Next-Generation Biomarker.

Cureus

February 2024

Pediatrics, SPZOZ (Samodzielny Publiczny Zakład Opieki Zdrowotnej) Krotoszyn, Krotoszyn, POL.

Heart failure, particularly in its advanced stages, significantly impacts quality of life. Despite progress in Guideline-Directed Medical Therapy (GDMT) and invasive treatments, heart transplantation (HT) remains the primary option for severe cases. However, complications such as graft rejection present significant challenges that necessitate effective monitoring.

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Aims: We aimed to analyse the characteristics and in-hospital outcomes of patients hospitalized for heart failure (HF) with co-morbid systemic sclerosis (SSc) and compare them to those without SSc, using data from the National Inpatient Sample from years 2016 to 2019.

Methods And Results: International Classification of Diseases, Tenth Revision diagnosis codes were used to identify hospitalized patients with a primary diagnosis of HF and secondary diagnoses of SSc from the National Inpatient Sample database from 2016 to 2019. Patients were divided into two groups: those with and without a secondary diagnosis of SSc.

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The Role of Multimodality Imaging in the Evaluation of Heart Failure and Surgical Transplant Planning of Patients with Adult Congenital Heart Disease.

Heart Fail Clin

April 2024

Department of Cardiology, Division of Cardiovascular Medicine, The Ohio State University, 473 W 12th Avenue, Davis Heart and Lung Research Institute, Columbus, OH 43210, USA.

Cardiac imaging is pivotal in evaluating ventricular function, residual lesions, and long-term complications in patients with adult congenital heart disease (ACHD). Longitudinal imaging in ACHD is key for the timely identification of patients requiring evaluation for advanced therapies. The guidelines recommend routine imaging surveillance.

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Background: Noninvasive methods for surveillance of acute rejection are increasingly used in heart transplantation (HT), including donor-derived cell-free DNA (dd-cfDNA). As other cardiac biomarkers differ by sex, we hypothesized that there may be sex-specific differences in the performance of dd-cfDNA for the detection of acute rejection. The purpose of the current study was to examine patterns of dd-cfDNA seen in quiescence and acute rejection in male and female transplant recipients.

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Impact of Advanced Therapy Centers on Characteristics and Outcomes of Heart Failure Admissions.

Circ Heart Fail

March 2024

Division of Cardiology, Department of Medicine (D.Y.L., J.K., I.Y., P.G., U.K., E.M.H., M.G.K., I.S., D.T.M., R.M.M., J.W.C., L.K.K.), Weill Cornell Medical College, New York Presbyterian Hospital, New York.

Background: Although much attention has been paid to admission and transfer patterns for cardiogenic shock, contemporary data are lacking on decompensated heart failure (HF) admissions and transfers and the impact of advanced therapy centers (ATCs) on outcomes.

Methods: HF hospitalizations were obtained from the Nationwide Readmissions Database 2016 to 2019. Centers performing at least 1 heart transplant or left ventricular assist device were classified as ATCs.

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A Curious Case of Left Ventricular Outflow Tract Velocity Time Integral Alternans With an Intra-Aortic Balloon Pump: Physiology in Action.

Am J Cardiol

May 2024

John T. Milliken Department of Medicine, Division of Cardiovascular Medicine, Barnes-Jewish Hospital, Washington University, St. Louis, Missouri; Section of Advanced Heart Failure and Cardiac Transplant, Division of Cardiology, Washington University, St. Louis, Missouri. Electronic address:

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Background: ProGlide is a percutaneous suture-mediated closure device used in arterial and venous closure following percutaneous intervention. Risk of vascular complications from use, particularly related to failure in hemostasis, or acute vessel closure, remains significant and often related to improper suture deployment. We describe a technique of ultrasound-guided ProGlide deployment in transfemoral transcatheter aortic valve implantation (TF-TAVI).

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Background: Disparities in pediatric heart transplant outcomes based on socioeconomic status (SES) have been previously observed. However, there is a need to reevaluate these associations in contemporary settings with advancements in transplant therapies and increased awareness of health disparities. This retrospective study aims to investigate the relationship between SES and outcomes for pediatric heart transplant patients.

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A 53-year-old man with inotrope-dependent advanced heart failure was admitted with acute decompensation and underwent urgent listing for heart transplant.

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Background: Preoperative kidney dysfunction is a risk factor for right heart failure (RHF) after implantation of a left ventricular assist device (LVAD). However, characteristic kidney function trajectories before and after post-LVAD RHF are uncertain, so we investigated this.

Methods And Results: We identified individuals who received primary continuous-flow LVAD implantation from July 1, 2014 to December 31, 2017 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data set.

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