scholarly journals Letter to the Editor: Delayed Presentation of Non-COVID-19 Patients During the COVID-19 Pandemic Is Not Limited to Children

2021 ◽  
Vol 12 (3) ◽  
pp. e0026
Author(s):  
Klaus Rose ◽  
◽  
Oishi Tanjinatus ◽  
Jane Grant-Kels ◽  
Earl B. Ettienne ◽  
...  
Keyword(s):  
Heart Failure ◽  
Down Syndrome ◽  
Head And Neck Cancer ◽  
Emergency Room ◽  
Ewing Sarcoma ◽  
Pulmonary Thromboembolism ◽  
Young Patients ◽  
The Other ◽  
Delayed Presentation ◽  
Pediatric Department

We read with interest the report about four minors who were diagnosed late with non-COVID-19 diseases during the COVID-19 pandemic. We would like to emphasize that, firstly, such delays are not limited to minors, and secondly, that also in minors should we distinguish the administrative and the physiological meanings of the term “child” and hence distinguish administratively defined “children” who bodily are already mature from those young patients who bodily are indeed still children. The 16-year-old patient that was presented to the emergency room with endocarditis was bodily no longer a child, although administratively and probably also psychologically, due to his Down syndrome, he was still a child. Two of the other patients, one with hemolytic anemia (2.5 years old) and one with Ewing sarcoma (4 years old), were still pre-pubertal children, while the 13-year-old minor with a septic hip was already adolescent. The author of the cited paper works in a pediatric department and reports those patients that he has seen during his work. However, in our view there is nothing specifically pediatric in his observations. Several recent papers discuss delays of diagnosis and treatment of non-COVID-19 diseases during the pandemic, including head and neck cancer, appendicitis, heart failure and septicemia, pulmonary thromboembolism,6 pyelonephritis, and cancer in general.8 Some patients in these papers are administratively still “children,” some are adults, and appendicitis is discussed in both.3,4 The delay the COVID-19 pandemic has caused in the timely diagnosis of various diseases is not a “pediatric” challenge, but a challenge for medicine in general.

NT-PROBNP AND THE CUT-OFF VALUE IN CARDIOVASCULAR DISEASES

2011 ◽  
pp. 5-12
Author(s):  
Anh Tien Hoang ◽  
Van Minh Huynh ◽  
Khanh Hoang ◽  
Huu Dang Tran ◽  
Viet An Tran
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Pilot Study ◽  
Cardiovascular Diseases ◽  
Clinical Application ◽  
European Society ◽  
The Other ◽  
Cardiac Marker ◽  
Cardiac Biomarker ◽  
European Society Of Cardiology

NT-ProBNP is a high value cardiac biomarker and widely applies in many cardiovascular diseases. The evaluation of concentration of NT-ProBNP needs the concern about age, gender, obesity and especially we need each cut-off point for each cause of cardiovascular disease in evaluation and clinical application. Because NT-ProBNP is a new cardiac marker and has been researched in 5 recent years, the cut-off of NT-ProBNP is still being studied for the clinical application in cardiovascular diseases. Only the cut-off of NT-ProBNP in diagnosis heart failure was guided by European Society of Cardiology. The meaning of introduce cut-off value of value plays an role as pilot study for the other relate study and brings the NT-ProBNP closely approach to clinical application.

Growth Differential Factor 15 (GDF%15), Possible Biomarker in Heart Failure

2017 ◽  
Vol 68 (3) ◽  
pp. 631-634
Author(s):  
Valeriu Gabi Dinca ◽  
Gheorghe Manole ◽  
Daniel Cochior ◽  
Alexandra Ligia Dinca
Keyword(s):  
Heart Failure ◽  
Serum Concentration ◽  
The Other ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
Other Hand ◽  
The One ◽  
Growth Differential

The present study aims at determining on the one hand the growth differentiation factor 15 significance as possible risk biomarker for this condition and, on the other hand, the degree of correlation between its serum concentration and the class of inotropism deficit.The value of the current research stems from the very selected theme, the activity of GDF-15, member of the superfamily of cytokines TGF-b recognized as having implication in atherosclerosis, but almost unexplored as role in the myocardiumremodeling processes, more precisely in fibrosis.

scholarly journals Long-term outcomes in young patients with atrioventricular block of unknown aetiology

2021 ◽  
Author(s):  
Johnni Resdal Dideriksen ◽  
Morten K Christiansen ◽  
Jens B Johansen ◽  
Jens C Nielsen ◽  
Henning Bundgaard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrioventricular Block ◽  
Ventricular Tachyarrhythmia ◽  
Pacemaker Implantation ◽  
Young Patients ◽  
Composite Endpoint ◽  
Unknown Aetiology ◽  
Successful Resuscitation

Abstract Aims Atrioventricular block (AVB) of unknown aetiology is rare in the young, and outcome in these patients is unknown. We aimed to assess long-term morbidity and mortality in young patients with AVB of unknown aetiology. Methods and results We identified all Danish patients younger than 50 years receiving a first pacemaker due to AVB between January 1996 and December 2015. By reviewing medical records, we included patients with AVB of unknown aetiology. A matched control cohort was established. Follow-up was performed using national registries. The primary outcome was a composite endpoint consisting of death, heart failure hospitalization, ventricular tachyarrhythmia, and cardiac arrest with successful resuscitation. We included 517 patients, and 5170 controls. Median age at first pacemaker implantation was 41.3 years [interquartile range (IQR) 32.7–46.2 years]. After a median follow-up of 9.8 years (IQR 5.7–14.5 years), the primary endpoint had occurred in 14.9% of patients and 3.2% of controls [hazard ratio (HR) 3.8; 95% confidence interval (CI) 2.9–5.1; P < 0.001]. Patients with persistent AVB at time of diagnosis had a higher risk of the primary endpoint (HR 10.6; 95% CI 5.7–20.0; P < 0.001), and risk was highest early in the follow-up period (HR 6.8; 95% CI 4.6–10.0; P < 0.001, during 0–5 years of follow-up). Conclusion Atrioventricular block of unknown aetiology presenting before the age of 50 years and treated with pacemaker implantation was associated with a three- to four-fold higher rate of the composite endpoint of death or hospitalization for heart failure, ventricular tachyarrhythmia, or cardiac arrest with successful resuscitation. Patients with persistent AVB were at higher risk. These findings warrant improved follow-up strategies for young patients with AVB of unknown aetiology.

scholarly journals Regional muscle-adipose distribution is different in patients with heart failure with preserved or reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Ishikawa ◽  
Y Izumiya ◽  
A Shibata ◽  
T Yoshida ◽  
H Hayashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Adipose Tissue ◽  
Ejection Fraction ◽  
Exercise Capacity ◽  
Exercise Tolerance ◽  
The Other ◽  
Reduced Ejection Fraction ◽  
Significant Difference ◽  
Regional Muscle

Abstract Background Epicardial adipose tissue (EAT) has been recognized to contribute inflammatory activity and atherosclerosis. On the other hand, it has been reported that the volume of EAT is lower in non-ischemic heart failure (HF) patients than healthy individuals. However, the difference in regional muscle-adipose distribution including EAT between HF with preserved ejection fraction (HFpEF) and HF reduced ejection fraction (HFrEF) has not been investigated. In addition, we investigated whether distribution of body composition contributed to exercise capacity. Methods The study included 105 non-ischemic HF patients diagnosed by cardiac catheterization between September 2017 and November 2019. Epicardial, abdominal and thigh muscle and adipose tissue volume were measured by computed tomography (CT), and exercise tolerance was evaluated by symptom-limited cardiopulmonary exercise test. Results Patients were divided into 2 groups according to the left ventricular ejection fraction, ≥40% as HFpEF (n=28) or <40% as HFrEF (n=77). There was no significant difference comorbidity, including hypertension, dyslipidemia, chronic kidney disease, and body mass index. Plasma B-type natriuretic peptide level was significantly higher in HFrEF than HFpEF group (146.2 vs 393.2 pg/ml, p<0.01), whereas, high-sensitive troponin T level was not different between two groups. Although there was no significant difference in BMI between two groups, the volume of EAT was significantly higher in HFpEF than HFrEF group (81.8 vs 136.4 ml, p=0.01). On the other hand, HFpEF had more thigh adipose tissue compared with HFrEF group (54.6 vs 42.1 ml, p=0.03). There were negative correlations between EAT volume and parameters of exercise capacity such as anaerobic threshold (r=−0.42, p<0.01) and peak VO2 (r=−0.32, p<0.01). Muscle volume itself does not corelate with these parameters. Conclusion In patient with nonischemic HF, the pattern of regional adipose distribution may have important role in pathologically. HFpEF and HFrEF has different pattern despite similar body mass index. These differences may be related to impaired exercise tolerance in these 2 different types of HF. Correlation between EAT and AT, peak VO2 Funding Acknowledgement Type of funding source: None

scholarly journals Age-Related Frailty: A Clinical Model for Geroscience?

2020 ◽  
Vol 24 (10) ◽  
pp. 1140-1143 ◽  
Author(s):  
Catherine Takeda ◽  
D. Angioni ◽  
E. Setphan ◽  
T. Macaron ◽  
P. De Souto Barreto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Medical History ◽  
Older Age ◽  
The Other ◽  
Everyday Practice ◽  
Clinical Model ◽  
Main Contributor ◽  
Age Related ◽  
History Of

AbstractIn their everyday practice, geriatricians are confronted with the fact that older age and multimorbidity are associated to frailty. Indeed, if we take the example of a very old person with no diseases that progressively becomes frail with no other explanation, there is a natural temptation to link frailty to aging. On the other hand, when an old person with a medical history of diabetes, arthritis and congestive heart failure becomes frail there appears an obvious relationship between frailty and comorbidity. The unsolved question is: Considering that frailty is multifactorial and in the majority of cases comorbidity and aging are acting synergistically, can we disentangle the main contributor to the origin of frailty: disease or aging? We believe that it is important to be able to differentiate age-related frailty from frailty related to comorbidity. In fact, with the emergence of geroscience, the physiopathology, diagnosis, prognosis and treatment will probably have to be different in the future.

scholarly journals Continuous infusion or bolus injection of loop diuretics for patients admitted for severe acute heart failure: Is one strategy better than the other?

2015 ◽  
Vol 34 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Francisca Caetano ◽  
Paula Mota ◽  
Inês Almeida ◽  
Andreia Fernandes ◽  
Ana Botelho ◽  
...  
Keyword(s):  
Heart Failure ◽  
Continuous Infusion ◽  
Acute Heart Failure ◽  
Bolus Injection ◽  
Loop Diuretics ◽  
The Other ◽  
Better Than

scholarly journals The Usefulness of Impedance Cardiography for Predicting Beneficial Effects of Cardiac Rehabilitation in Patients with Heart Failure

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Grzegorz Gielerak ◽  
Paweł Krzesiński ◽  
Ewa Piotrowicz ◽  
Ryszard Piotrowicz
Keyword(s):  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Exercise Tolerance ◽  
Impedance Cardiography ◽  
The Other ◽  
Pronounced Increase ◽  
Fluid Content ◽  
Beneficial Effects ◽  
Patients With Heart Failure ◽  
Before And After

Aim. Cardiac rehabilitation (CR) is an important part of heart failure (HF) treatment. The aim of this paper was to evaluate if thoracic fluid content (TFC) measured by impedance cardiography (ICG) is a useful parameter for predicting the outcome of CR.Methods. Fifty HF patients underwent clinical and noninvasive haemodynamic (TFC) assessments before and after 8-week CR.Results. As a result of CR, the patients’ exercise tolerance improved, especially in terms of peak VO2(18.7 versus 20.8 mL × kg−1× min−1;P=0.025). TFC was found to identify patients with significantly improved peak VO2after CR. “High TFC” patients (TFC > 27.0 kOhm−1), compared to those of “low TFC” (TFC < 27.0 kOhm−1), were found to have more pronounced increase in peak VO2(1.3 versus 3.1 mL × kg−1× min−1;P=0.011) and decrease in TFC (4.0 versus 0.7 kOhm−1;P<0.00001). On the other hand, the patients with improved peak VO2(n=32) differed from those with no peak VO2improvement in terms of higher baseline TFC values (28.4 versus 25.3 kOhm−1;P=0.039) and its significant decrease after CR (2.7 versus 0.2 kOhm−1;P=0.012).Conclusions. TFC can be a useful parameter for predicting beneficial effects of CR worth including in the process of patients’ qualification for CR.

Comparison of lung bedside ultrasound and BNP in the diagnosis of acute heart failure in the emergency department

2020 ◽  
Vol 8 (1) ◽  
pp. 50-50
Author(s):  
Seyed Hossein Ojaghi Haghighi ◽  
Neda Hamed ◽  
Shiva Ebrahimi ◽  
Jafar Ghobadi ◽  
Hoorolnesa Ameli
Keyword(s):  
Heart Failure ◽  
Emergency Room ◽  
Pulmonary Edema ◽  
Acute Heart Failure ◽  
Lung Ultrasound ◽  
P Value ◽  
Ultrasound Evaluation ◽  
Ultrasound Findings ◽  
Medical Advances ◽  
B Lines

Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.

scholarly journals Cardiac Protection of Valsartan on Juvenile Rats with Heart Failure by Inhibiting Activity of CaMKII via Attenuating Phosphorylation

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Yao Wu ◽  
Feifei Si ◽  
Xiaojuan Ji ◽  
Kunfeng Jiang ◽  
Sijie Song ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Myocyte ◽  
Pressure Overload ◽  
The Other ◽  
Calcium Handling ◽  
Juvenile Rats ◽  
Abdominal Aortic ◽  
Calcium Handling Proteins ◽  
Increased Activity ◽  
Induce Heart Failure

Background. This study was undertaken to determine relative contributions of phosphorylation and oxidation to the increased activity of calcium/calmodulin-stimulated protein kinase II (CaMKII) in juveniles with cardiac myocyte dysfunction due to increased pressure overload. Methods. Juvenile rats underwent abdominal aortic constriction to induce heart failure. Four weeks after surgery, rats were then randomly divided into two groups: one group given valsartan (HF + Val) and the other group given placebo (HF + PBO). Simultaneously, the sham-operated rats were randomly given valsartan (Sham + Val) or placebo (Sham + PBO). After 4 weeks of treatment, Western blot analysis was employed to quantify CaMKII and relative calcium handling proteins (RyR2 and PLN) in all groups. Results. The deteriorated cardiac function was reversed by valsartan treatment. In ventricular muscle cells of group HF + PBO, Thr287 phosphorylation of CaMKII and S2808 phosphorylation of RyR2 and PLN were increased and S16 phosphorylation of PLN was decreased compared to the other groups, while Met281 oxidation was not significantly elevated. In addition, these changes in the expression of calcium handling proteins were ameliorated by valsartan administration. Conclusions. The phosphorylation of Thr286 is associated with the early activation of CaMKII rather than the oxidation of Met281.

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