| 781. |
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| 782. |
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| 783. |
- Solbeck, Sacha, et al.
(författare)
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Monitoring of dabigatran anticoagulation and its reversal in vitro by thrombelastography.
- 2014
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 176:3, s. 794-799
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Tidskriftsartikel (refereegranskat)abstract
- Dabigatran etexilate, a pro-drug of a direct thrombin inhibitor, was approved a few years ago for non-valvular atrial fibrillation and deep venous thrombosis. Rapid monitoring of the dabigatran level is essential in trauma and bleeding patients but the traditional plasma-based assays may not sufficiently display the effect. Furthermore, no antidote exists and reversal of the anticoagulant effect is impossible or difficult. The present study investigated the in vitro effect of dabigatran on whole blood thromboelastography (TEG) and its reversal by recombinant activated factor VII and prothrombin complex concentrate.
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| 784. |
- Tasevska, Gordana, et al.
(författare)
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Gender differences in variables related to B-natriuretic peptide, left ventricular ejection fraction and mass, and peak oxygen consumption, in patients with heart failure.
- 2011
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; Apr 7, s. 364-371
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Tidskriftsartikel (refereegranskat)abstract
- AIM AND METHODS: We assessed gender differences in variables related to B-natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), peak oxygen consumption (peak-VO2), and LV mass (LVM), among patients recently hospitalized for suspected heart failure (HF). RESULTS: Of 930 consecutive patients, 409 accepted follow-up after discharge, 221 of these had definite HF (90 women, mean age 74.5 [9.8]years). In 141 HF patients (61 women) with BNP data, women had lower BNP than men (43.9 [38.1] versus 76.3 [88.9]pmol/L, P=0.0193). LVEF (all HF patients) was higher in women (49.8 [13.4] versus 42.4 [13.9]%, P=0.0004). Peak-VO2 (147 HF patients, 48 women) was lower in women (13.9 [4.3] versus 16.3 [4.2]mL/kg/min, P=0.0093). LVM index (200 HF patients, 78 women) was lower in women (130.4 [46.5] versus 171.7 [57.6]g/m(2), P<0.0001). Among HF patients, variables independently related to BNP were body mass index (BMI) and peak-VO2 exclusively among men, mitral regurgitation, respiratory disease and angiotensin receptor blocker treatment only among women. Variables independently related to LVEF were resting heart rate, acetylic salicylic acid use and BNP exclusively among men. No variable was exclusive for women. Variables independently related to peak-VO2 were right ventricular size, BNP, resting and peak heart rate solely among men, BMI and stable angina pectoris exclusively among women. Variables independently related to LVM were left atrial diameter only among men, BMI exclusively among women. CONCLUSION: Among elderly HF patients, there were some important gender differences in BNP, LVEF, peak-VO2 and LVM, and in variables independently related to these factors.
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| 785. |
- Tavazzi, L., et al.
(författare)
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Clinical profiles and outcomes in patients with chronic heart failure and chronic obstructive pulmonary disease: An efficacy and safety analysis of SHIFT study
- 2013
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 170:2, s. 182-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) frequently coexist, with undefined prognostic and therapeutic implications. We investigated clinical profile and outcomes of patients with chronic HF and COPD, notably the efficacy and safety of ivabradine, a heart rate-reducing agent. METHODS: 6505 ambulatory patients, in sinus rhythm, heart rate >/=70bpm and stable systolic HF were randomised to placebo or ivabradine (2.5 to 7.5mg bid). Multivariate Cox model analyses were performed to compare the COPD (n=730) and non-COPD subgroups, and the ivabradine and placebo treatment effects. RESULTS: COPD patients were older and had a poorer risk profile. Beta-blockers were prescribed to 69% of COPD patients and 92% of non-COPD patients. The primary endpoint (PEP) and its component, hospitalisation for worsening HF, were more frequent in COPD patients (HRs f, 1.22 [p=0.006]; and 1.34 [p<0.001]) respectively, but relative risk was reduced similarly by ivabradine in both COPD (14%, and 17%) and non-COPD (18% and 27%) patients (p interaction=0.82, and 0.53, respectively). Similar effect was noted also for cardiovascular death. Adverse events were more common in COPD patients, but similar in treatment subgroups. Bradycardia occurred more frequently in ivabradine subgroups, with similar incidence in patients with or without COPD. CONCLUSIONS: The association of COPD and HF results in a worse prognosis, and COPD represents a barrier to optimisation of beta-blocker therapy. Ivabradine is similarly effective and safe in chronic HF patients with or without COPD, and can be safely combined with beta-blockers in COPD.
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| 786. |
- Thilén, Ulf, et al.
(författare)
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Atrial myocardial pathoelectrophysiology in adults with a secundum atrial septal defect is unaffected by closure of the defect. A study using high resolution signal-averaged orthogonal P-wave technique.
- 2009
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 132, s. 364-368
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In patients with atrial septal defect (ASD) the P-wave is prolonged as a marker of delayed atrial conduction which is associated with atrial fibrillation. The study aim was to analyse the impact of ASD closure in adults on P-wave duration and morphology by means of signal-averaged P-waves (PSA-ECG) and to investigate potential mechano-electrical interactions. METHODS: PSA-ECG was obtained before and 8+/-6 months after ASD closure in 35 adult patients (age 53+/-15 years). Heart chamber sizes and pulmonary artery pressure levels were assessed by echoDopplercardiography. RESULTS: P-wave duration and morphology did not change after ASD closure (148+/-16 vs 144+/-16 ms, P=0.07). P-wave duration did not relate to age at repair, preclosure atrial sizes or pulmonary artery pressure. Pre- or postclosure atrial fibrillation propensity was associated with longer P-wave duration both before and after ASD closure. CONCLUSION: Atrial conduction disturbances in middle-aged patients with ASD, manifested as a prolonged P-wave duration, do not change after ASD closure and are not related to the dilatation of the right and left atria. It is suggestive that atrial conduction disturbance associated with ASD develop early and early intervention is required to prevent the development of late atrial fibrillation.
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| 787. |
- Thilén, Ulf, et al.
(författare)
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Closure of atrial septal defect in the adult. Cardiac remodeling is an early event.
- 2006
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 108:3, s. 370-375
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Tidskriftsartikel (refereegranskat)abstract
- Background: Study aimed to describe the extent and the temporal profile of cardiac remodeling after atrial septal defect closure in the adult. Methods: Prospective and longitudinal echocardiographic assessment of right and left heart size before and after (1 day-1 week/1/4/12 months) surgical or catheter-based atrial septal closure in 39 adults (age 54 15 years). Results: Right ventricular and atrial sizes were markedly reduced, left ventricular size increased and left atrial size remained unchanged after closure. Older age and a history of atrial fibrillation reduced the potential to normalize right and left atrial size after closure. The greater part of the changes occurred very early, in the 1st day/1st week, From then on the speed of change gradually diminished and after 4 months no important changes were observed. The mode of closure did not influence the degree or the pace of the remodeling. Conclusion: Cardiac remodeling after atrial septal closure in the adult is a common and early event that seems by and large completed within the first half year after closure. The ventricles seem to have a higher capacity of remodeling than the atria in this setting. The mode of closure does not seem to significantly impact remodeling. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 788. |
- Tingberg, Erik, et al.
(författare)
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Lipid peroxidation is not increased in heart failure patients on modern pharmacological therapy.
- 2006
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 112:3, s. 275-281
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies support a role of oxygen-free radicals in the development of congestive heart failure (CHF). The aim of this study was to investigate whether lipid peroxidation is increased in CHF patients on modem pharmacological therapy and whether there is a positive correlation between plasma levels of markers of lipid peroxidation and severity of heart failure (HF). Plasma malondialdehyde (MDA) and isoprostanes are often used as markers of lipid peroxidation and oxidative stress. We also studied whether long-term treatment with isosorbide-5-mononitrate (IS-5-MN) in combination with standard HF therapy affects P-MDA levels in patients with evidence of left ventricular (LV) dysfunction following acute myocardial infarction (AMI). Materials and methods: Ninety-two patients with clinical or echocardiographic evidence of LV-dysfunction following AMI were randomized to treatment with either IS-5-MN or placebo. In a subgroup of 83 patients with available plasma MDA, echocardiography, right-heart catherization, and plasma natriuretic peptides were evaluated. Control subjects were 80 healthy blood donors. A second study group consisted of 56 patients with CHF, evaluated with respect to LV function, brain natriuretic peptide and markers of oxidative stress (P-MDA and 8-isoprostane). The second control group comprised 50 healthy subjects. Results: Lipid peroxidation measured by P-MDA and 8-isoprostane was not increased in patients with LV dysfunction treated with standard HF therapy. No positive correlation was found to the severity of HE Long-term IS-5-MN therapy did not influence P-MDA concentrations. Conclusions: Although results from many experimental and clinical studies suggest that oxidative stress is increased in HF, this may not be true for patients treated with beta blockers and inhibitors of the renin-angiotensin system. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 789. |
- Tygesen, H, et al.
(författare)
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Potential risk of beta-blockade withdrawal in congestive heart failure due to abrupt autonomic changes.
- 1999
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Ingår i: International journal of cardiology. - 0167-5273. ; 68:2, s. 171-7
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Tidskriftsartikel (refereegranskat)abstract
- Beta-Blockers reduce mortality in patients with congestive heart failure and a proposed mechanism has been changes of autonomic tone. Heart rate variability is a non-invasive tool to estimate cardiac autonomic tone. The aim was to study changes of heart rate variability in patients with congestive heart failure on placebo, on the beta1-selective antagonist metoprolol or 24 h after metoprolol withdrawal. Forty-five patients with congestive heart failure were studied with Holter recordings. Heart rate variability measurements were performed before, after 6-12 months of treatment with 150 mg metoprolol/placebo, or 24 h after discontinued metoprolol. After treatment, patients on beta-blockade had a significantly longer mean RR interval and changes of heart rate variability, suggesting elevated vagal tone. Patients monitored in the rebound phase of beta-blocker withdrawal had a significant vagal reduction to the level of the placebo group. There was also a nonsignificant trend towards increased sympathetic tone (LF/HF over 24 h), compared with the beta-blockade group. Heart rate variability indicates an elevated vagal tone during treatment with metoprolol but beta-blockade withdrawal shifts the autonomic balance towards lower vagal and higher sympathetic tone within 24 h. These results could imply a potential risk when abruptly discontinuing beta-blockade medication in these patients.
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| 790. |
- Van de Ven, Louis L. M., et al.
(författare)
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The effect of treatment with bisoprolol-first versus enalapril-first on cardiac structure and function in heart failure
- 2010
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 144:1, s. 59-63
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Tidskriftsartikel (refereegranskat)abstract
- Background: In CIBIS III, initiating chronic heart failure (CHF) treatment with bisoprolol (target dose 10 mg q.d.) followed by combination therapy with enalapril (target dose 10 mg b.i.d.), compared to the opposite order, showed similar effects on survival and hospitalization. By echocardiography, we evaluated the effects of these treatment strategies on cardiac structure and function. Methods: In a single-centre substudy, we compared the impact on left ventricular (LV) dimensions and ejection fraction (EF) of treatment with bisoprolol-first (n = 21) and enalapril-first (n = 19) in 40 beta-blocker and angiotensin-converting-enzyme-inhibitor naive patients, with stable, mild or moderate CHF (NYHA II-III) and LVEF <= 35%. Echocardiography was performed at baseline, after the 6-month monotherapy phase and after 12 months, i.e. after 6 months combination therapy. Results: Baseline characteristics were similar across treatment groups. After 6 months LVEF increased by 5.1 +/- 4.0 EF-% (P<0.0001) with Bisoprolol and 4.0 +/- 4.0 EF-% (P = 0.0005), with enalapril (between-group P = 0.47). LV end-diastolic volume (LVEDV) decreased by 8.1 +/- 4.7 ml (P<0.0001) with bisoprolol and by 4.6 +/- 8.2 ml (P = 0.03) with enalapril (between-group P = 0.16). Mean wall thickness (WT) decreased by 0.31 +/- 0.43 mm (P = 0.004) with bisoprolol and by 0.18 +/- 0.48 mm (P = 0.11) with enalapril (between-group P = 0.29). From baseline to 12 months, LVEF increased by 7.5 +/- 4.0 EF-% (P<0.0001) in Bisoprolol first group and 6.0 +/- 4.6 EF-% (P<0.0001), in the enalapril first group (between-group P = 0.31). LVEDV decreased by 12.9 +/- 6.3 ml (P<0.0001) with bisoprolol-first and by 7.9 +/- 7.7 ml (P = 0.0006) with enalapril-first (between-group P = 0.16) and WT decreased by 0.38 +/- 0.44 mm (P = 0.0008) and 0.59 +/- 0.54 mm (P = 0.0004), respectively (between-group P = 0.10). Conclusion: During both monotherapy and combined therapy, bisoprolol-first and enalapril-first similarly reversed cardiac remodelling and improved LVEF. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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