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Sample records for bileaflet mechanical heart

  1. Mechanical heart valve cavitation in patients with bileaflet valves.

    Science.gov (United States)

    Johansen, Peter; Andersen, Tina S; Hasenkam, J Michael; Nygaard, Hans; Paulsen, Peter K

    2014-01-01

    Today, the quality of mechanical heart valves is quite high, and implantation has become a routine clinical procedure with a low operative mortality (valves are thought of having higher cavitation potential than bileaflet valves due to higher closing velocities. However, the thromboembolic potential seems to be the same. Further studies are therefore needed to investigate the cavitation potential of bileaflet valves in vivo. The post processing of HFPF have shown difficulties when applied on bileaflet vavles due to asynchronous closure of the two leaflets. The aim of this study was therefore to isolate the pressure signature from each leaflet closure and perform cavitation analyses on each component. Six patients were included in the study (St. Jude Medical (n=3) and CarboMedics (n=3); all aortic bileaflet mechanical heart valves). HFPFs were recorded intraoperatively through a hydrophone at the aortic root. The pressure signature relating to the first and second leaflet closure was isolated and cavitation parameters were calculated (RMS after 50 kHz highpass filtering and signal energy). Data were averaged over 30 heart cycles. For all patients both the RMS value and signal energy of the second leaflet closure were higher than for the first leaflet closure. This indicates that the second leaflet closure is most prone to cause cavitation. Therefore, quantifying cavitation based on the HFPF related to the second leaflet closure may suggest that the cavitation potential for bileaflet valves in vivo may be higher than previous studies have suggested. PMID:25571278

  2. Effects of bileaflet mechanical heart valve orientation on coronary flow

    Science.gov (United States)

    Haya, Laura; Tavoularis, Stavros

    2015-11-01

    The aortic sinus is approximately tri-radially symmetric, but bileaflet mechanical heart valves (BMHVs), which are commonly used to replace diseased aortic valves, are bilaterally symmetric. This mismatch in symmetry suggests that the orientation in which a BMHV is implanted within the aortic sinus affects the flow characteristics downstream of it. This study examines the effect of BMHV orientation on the flow in the coronary arteries, which originate in the aortic sinus and supply the heart tissue with blood. Planar particle image velocimetry measurements were made past a BMHV mounted at the inlet of an anatomical aorta model under physiological flow conditions. The complex interactions between the valve jets, the sinus vortex and the flow in the right coronary artery were elucidated for three valve orientations. The coronary flow rate was directly affected by the size, orientation, and time evolution of the vortex in the sinus, all of which were sensitive to the valve's orientation. The total flow through the artery was highest when the valve was oriented with its axis of symmetry intersecting the artery's opening. The findings of this research may assist surgeons in choosing the best orientation for BMHV implantation. The bileaflet valve was donated by St. Jude Medical. Financial support was provided by the Natural Sciences and Engineering Research Council of Canada.

  3. Experimental Observation on Antithrombotic Property of A New Bileaflet Mechanical Heart Valve in Sheep

    Institute of Scientific and Technical Information of China (English)

    LOU Hai-fang; XU Si-wei

    2008-01-01

    Objective: To observe the antithrombotic property of a new all-pyrolytic car-bon bileaflet mechanical heart valve so as to provide evidence for clinical practice. Meth-ods: 15 sheep underwent mitral valve replacement (MVR) with this new mechanical valve. Each animal was placed on cardiopulmonary bypass. All of the sheep were given in an anticoagulation protocol and followed for three months. Final studies were performed on all animals surviving for more than 12 weeks. Results: 10 sheep died within 48 h after op-eration, 5 sheep survived. The long-term survivors were killed for autopsies,2 sheep were killed after 1 week, 1 after 12 weeks and 2 after two and half years. Pathological examina-tion of 10 sheep which died early after operation revealed that there was neither evidence of thrombosis nor any failure of the mechanical valve. Autopsy studies in the 5 long-term survivors revealed that the sewing ring was covered by a thin layer of microthrombi consis-ted most of platelets and fibrin after 1 week. The sewing ring was covered by a tissue lay-er, with partial organized microthrombi and endothelialization after 12 weeks. Two and half years after operation, the complete endothelialization presented around the sewing ring without restriction of bileaflet motion. The tissue ingrowth tends to stop at the pyrolytic carbon-fabric interface on both surfaces of left atrium and ventricle. This study demonstra-ted that the new prosthetic heart valve had not promoted thrombosis and thrombembolism.

  4. Mitigation of Shear-Induced Blood Damage by Mechanical Bileaflet Heart Valves

    Science.gov (United States)

    Zakharin, Boris; Arjunon, Sivakkumar; Saikrishnan, Neelakantan; Yoganathan, Ajit; Glezer, Ari

    2010-11-01

    The strong transitory shear stress generated during the time-periodic closing of bileaflet mechanical heart valves that is associated with the formation of counter-rotating vortices near the leaflet edges may be damaging to blood elements and may result in platelet activation and therefore thrombosis and thromboembolism complications. These flow transients are investigated using fluorescent PIV in a new, low-volume test setup that reproduces the pulsatile physiological conditions associated with a 25 mm St. Jude Medical valve. The flow transients are partially suppressed and the platelet activation is minimized using miniature vortex generator arrays that are embedded on the surface of the leaflets. Measurements of the ensuing flow taken phase-locked to the leaflet motion demonstrate substantial modification of the transient vertical structures and concomitant reduction of Reynolds shear stresses. Human blood experiments validated the effectiveness of miniature vortex generators in reducing thrombus formation by over 42 percent.

  5. Manipulation of the closing transients of bileaflet mechanical heart valves using passive, surface-mounted elements

    Science.gov (United States)

    Simon, Helene

    2005-11-01

    The time-periodic closing of bileaflet mechanical heart valves is accompanied by a strong flow transient that is associated with the formation of a counter-rotating vortex pair near the b-datum line of leaflet edges. The strong transitory shear that is generated by these vortices may be damaging to blood elements and may result in platelet activation. In the present work, these flow transients are mitigated using miniature vortex generator arrays that are embedded on the surface of the leaflets. The closing transients in the absence and presence of the passive vortex generators are characterized using PIV measurements that are phase locked to the leaflet motion. The study utilizes a 25 mm St. Jude Medical valve placed in the aortic position of the Georgia Tech left heart simulator. The valve is subjected to physiological flow conditions: a heart rate of 70 bpm; a cardiac output of 5 l/min; and a mean aortic pressure of 90 mmHg. Measurements of the velocity field in the center plane of the leaflets demonstrate that the dynamics of the transient vortices that precede the formation of the leakage jets can be significantly altered and controlled by relatively simple passive modifications of existing valve designs.

  6. Blood Damage Through a Bileaflet Mechanical Heart Valve: A Quantitative Computational Study Using a Multiscale Suspension Flow Solver

    OpenAIRE

    Min Yun, B.; Aidun, Cyrus K.; Yoganathan, Ajit P.

    2014-01-01

    Bileaflet mechanical heart valves (BMHVs) are among the most popular prostheses to replace defective native valves. However, complex flow phenomena caused by the prosthesis are thought to induce serious thromboembolic complications. This study aims at employing a novel multiscale numerical method that models realistic sized suspended platelets for assessing blood damage potential in flow through BMHVs. A previously validated lattice-Boltzmann method (LBM) is used to simulate pulsatile flow th...

  7. Effect of vortex generators on the closing transient flow of bileaflet mechanical heart valves

    Science.gov (United States)

    Murphy, David; Dasi, Lakshmi; Yoganathan, Ajit; Glezer, Ari

    2006-11-01

    The time-periodic closing of bileaflet mechanical heart valves is accompanied by a strong flow transient that is associated with the formation of a counter-rotating vortex pair near the b-datum line of leaflet edges. The strong transitory shear that is generated by these vortices may be damaging to blood elements and may result in platelet activation. In the present work, these flow transients are mitigated using miniature vortex generator arrays that are embedded on the surface of the leaflets. Two vortex generator designs were investigated: one design comprised staggered rectangular fins and the other one staggered hemispheres. The closing transients in the absence and presence of the passive vortex generators are characterized using phase locked PIV measurements. The study utilizes a 25 mm St. Jude Medical valve placed in the aortic position of the Georgia Tech left heart simulator. Measurements of the velocity field in the center plane of the leaflets demonstrate that the dynamics of the transient vortices that precede the formation of the leakage jets can be significantly altered and controlled by relatively simple passive modifications of existing valve designs. Human blood experiments validated the effectiveness of miniature vortex generators in reducing thrombus formation by over 42 percent.

  8. Mitigation of Shear-Induced Blood Damage of Mechanical Bileaflet Heart Valves using Embedded Vortex Generators

    Science.gov (United States)

    Hidalgo, Pablo; Arjunon, Sivakkumar; Saikrishnan, Neelakantan; Yoganathan, Ajit; Glezer, Ari

    2012-11-01

    The strong transitory shear stress generated during the time-periodic closing of the mechanical prosthetic bileaflet aortic heart valve, is considered to be one of the main factors responsible for complications, associated with thrombosis and thromboembolism. These flow transients are investigated using phase and time-averaged PIV in a low-volume (about 150 ml) test setup that simulates the pulsatile physiological conditions associated with a 23 mm St. Jude Medical valve. The PIV measurements are accompanied by continuous monitoring of the ventricular and aortic pressures and valve flow rate. Following the valve closure, the leakage flow between the valve leaflets is caused by the pressure buildup across the leaflets, leading to the formation of a regurgitation jet starting from the BMHV B-datum line. As in a typical starting jet, a counter-rotating vortex pair is formed along each leaflet edge and the vorticity sheet is associated with high shear stress that may be result in blood platelet activation. The present investigation demonstrates that the placement of arrays of mm-scale vortex generators near the edges of the leaflets diffuses the vortex sheet and suppresses the formation of these vortices, weakening the local velocity gradients and small-scale vortical structures. Supported by NIH and NSF.

  9. A numerical investigation of blood damage in the hinge area of bileaflet mechanical heart valves

    Science.gov (United States)

    Yun, Min; Wu, Jingshu; Simon, Helene; Sotiropoulos, Fotis; Aidun, Cyrus; Yoganathan, Ajit

    2010-11-01

    Studies have shown that high shear stress and large recirculation regions have a strong impact on thromboembolic complications in Bileaflet mechanical heart valves (BMHV). This study quantitatively compares the hinge flow field and blood damage of the 23mm St. Jude Medical (SJM) regent with different hinge gap widths and the 23mm CarboMedics (CM) valves. The lattice-Boltzmann method with external boundary force (LBM-EBF) [Wu and Aidun, Int. J Num. Methods Fluids, 62, 7, 2009] was implemented to simulate the flow and capture the dynamics and the surface shear stress of the platelets with realistic geometry. The velocity boundary conditions for the small-scale hinge flow are obtained from previous 3D large-scale computational fluid dynamics (CFD) simulations [Simon et al, Annals of Biomedical Engineering, 38, 3, 2009]. The flow patterns of three hinges that were studied were similar during diastole. However, velocity magnitudes and shear stresses at the hinge gap were different, which may explain the higher blood damage index (BDI) value for the CM valve and lower BDI value for the SJM valve with a larger gap width. The multiscale computational method used to quantitatively measure the BDI during a full cardiac cycle will be discussed.

  10. Vorticity dynamics of a bileaflet mechanical heart valve in an axisymmetric aorta

    Science.gov (United States)

    Dasi, L. P.; Ge, L.; Simon, H. A.; Sotiropoulos, F.; Yoganathan, A. P.

    2007-06-01

    We present comprehensive particle image velocimetry measurements and direct numerical simulation (DNS) of physiological, pulsatile flow through a clinical quality bileaflet mechanical heart valve mounted in an idealized axisymmetric aorta geometry with a sudden expansion modeling the aortic sinus region. Instantaneous and ensemble-averaged velocity measurements as well as the associated statistics of leaflet kinematics are reported and analyzed in tandem to elucidate the structure of the velocity and vorticity fields of the ensuing flow-structure interaction. The measurements reveal that during the first half of the acceleration phase, the flow is laminar and repeatable from cycle to cycle. The valve housing shear layer rolls up into the sinus and begins to extract vorticity of opposite sign from the sinus wall. A start-up vortical structure is shed from the leaflets and is advected downstream as the leaflet shear layers become wavy and oscillatory. In the second half of flow acceleration the leaflet shear layers become unstable and break down into two von Karman-like vortex streets. The onset of vortex shedding from the valve leaflets is responsible for the growth of significant cycle-to-cycle vorticity oscillations. At peak flow, the housing and leaflet shear layers undergo secondary instabilities and break down rapidly into a chaotic, turbulent-like state with multiple small-scale vortical structures emerging in the flow. During the deceleration and closing phases all large-scale coherent flow features disappear and a chaotic small-scale vorticity field emerges, which persists even after the valve has closed. Probability density functions of the leaflet position during opening and closing phases show that the leaflet position fluctuates from cycle to cycle with larger fluctuations evident during valve closure. The DNS is carried out by prescribing the leaflet kinematics from the experimental data. The computed instantaneous vorticity fields are in very good

  11. Computational Simulations of Flow Dynamics and Blood Damage Through a Bileaflet Mechanical Heart Valve Scaled to Pediatric Size and Flow

    OpenAIRE

    Yun, B. Min; McElhinney, Doff B.; Arjunon, Shiva; Mirabella, Lucia; Aidun, Cyrus K.; Yoganathan, Ajit P.

    2014-01-01

    Despite pressing needs, there are currently no FDA approved prosthetic valves available for use in the pediatric population. This study is performed for predictive assessment of blood damage in bileaflet mechanical heart valves (BMHVs) with pediatric sizing and flow conditions. A model of an adult-sized 23mm St. Jude Medical (SJM) Regent™ valve is selected for use in simulations, which is scaled in size for a 5-year old child and 6-month old infant. A previously validated lattice-Boltzmann me...

  12. Effect of heart rate on the hemodynamics of bileaflet mechanical heart valves' prostheses (St. Jude Medical) in the aortic position and in the opening phase: A computational study.

    Science.gov (United States)

    Jahandardoost, Mehdi; Fradet, Guy; Mohammadi, Hadi

    2016-03-01

    To date, to the best of the authors' knowledge, in almost all of the studies performed around the hemodynamics of bileaflet mechanical heart valves, a heart rate of 70-72 beats/min has been considered. In fact, the heart rate of ~72 beats/min does not represent the entire normal physiological conditions under which the aortic or prosthetic valves function. The heart rates of 120 or 50 beats/min may lead to hemodynamic complications, such as plaque formation and/or thromboembolism in patients. In this study, the hemodynamic performance of the bileaflet mechanical heart valves in a wide range of normal and physiological heart rates, that is, 60-150 beats/min, was studied in the opening phase. The model considered in this study was a St. Jude Medical bileaflet mechanical heart valve with the inner diameter of 27 mm in the aortic position. The hemodynamics of the native valve and the St. Jude Medical valve were studied in a variety of heart rates in the opening phase and the results were carefully compared. The results indicate that peak values of the velocity profile downstream of the valve increase as heart rate increases, as well as the location of the maximum velocity changes with heart rate in the St. Jude Medical valve model. Also, the maximum values of shear stress and wall shear stresses downstream of the valve are proportional to heart rate in both models. Interestingly, the maximum shear stress and wall shear stress values in both models are in the same range when heart rate is St. Jude Medical valve model when heart rate is >90 beats/min (up to ~40% growth compared to that of the native valve). The findings of this study may be of importance in the hemodynamic performance of bileaflet mechanical heart valves. They may also play an important role in design improvement of conventional prosthetic heart valves and the design of the next generation of prosthetic valves, such as percutaneous valves. PMID:26786673

  13. Effect of heart rate on the hemodynamics of bileaflet mechanical heart valves' prostheses (St. Jude Medical) in the aortic position and in the opening phase: A computational study.

    Science.gov (United States)

    Jahandardoost, Mehdi; Fradet, Guy; Mohammadi, Hadi

    2016-03-01

    To date, to the best of the authors' knowledge, in almost all of the studies performed around the hemodynamics of bileaflet mechanical heart valves, a heart rate of 70-72 beats/min has been considered. In fact, the heart rate of ~72 beats/min does not represent the entire normal physiological conditions under which the aortic or prosthetic valves function. The heart rates of 120 or 50 beats/min may lead to hemodynamic complications, such as plaque formation and/or thromboembolism in patients. In this study, the hemodynamic performance of the bileaflet mechanical heart valves in a wide range of normal and physiological heart rates, that is, 60-150 beats/min, was studied in the opening phase. The model considered in this study was a St. Jude Medical bileaflet mechanical heart valve with the inner diameter of 27 mm in the aortic position. The hemodynamics of the native valve and the St. Jude Medical valve were studied in a variety of heart rates in the opening phase and the results were carefully compared. The results indicate that peak values of the velocity profile downstream of the valve increase as heart rate increases, as well as the location of the maximum velocity changes with heart rate in the St. Jude Medical valve model. Also, the maximum values of shear stress and wall shear stresses downstream of the valve are proportional to heart rate in both models. Interestingly, the maximum shear stress and wall shear stress values in both models are in the same range when heart rate is valve model when heart rate is >90 beats/min (up to ~40% growth compared to that of the native valve). The findings of this study may be of importance in the hemodynamic performance of bileaflet mechanical heart valves. They may also play an important role in design improvement of conventional prosthetic heart valves and the design of the next generation of prosthetic valves, such as percutaneous valves.

  14. The Application of Bileaflet Mechanical Heart Valves in the Polish Ventricular Assist Device: Physical and Numerical Study and First Clinical Usage.

    Science.gov (United States)

    Malota, Zbigniew; Sadowski, Wojciech; Krzyskow, Marek; Stolarzewicz, Bogdan

    2016-03-01

    The Polish ventricular assist device (Polvad) has been used successfully in clinical contexts for many years. The device contains two single-disc valves, one at the inlet and one at the outlet connector of the pneumatic pump. Unfortunately, in recent years, a problem has occurred with the availability of single-disc valves. This article presents the possibility of using bileaflet mechanical heart valve prostheses in the Polvad to avoid a discontinuity in clinical use. The study is based on experimental and numerical simulations and comparison of the distribution of flow, pressure, and stress (wall, shear, and turbulent) inside the Polvad chamber and the inlet/outlet connectors fitted with Sorin Monodisc and Sorin Bicarbon Fitline valves. The type and orientation of the inlet valve affects valve performance and flow distribution inside the chamber. Near-wall flow is observed for single-disc valves. In the case of bileaflet valves, the main jet is directed more centrally, with lower shear stress but higher turbulent stress in comparison with single-disc valves. For clinical usage, a 45° orientation of the bileaflet inlet valve was chosen, as this achieves good washing of the inlet area near the membrane paste surface. The Polvad with bileaflet valves has now been used successfully in our clinic for over a year and will continue to be used until new assist devices for heart support are developed.

  15. Effect of Hinge Gap Width of a St. Jude Medical Bileaflet Mechanical Heart Valve on Blood Damage Potential—An In Vitro Micro Particle Image Velocimetry Study

    OpenAIRE

    Jun, Brian H.; Saikrishnan, Neelakantan; Arjunon, Sivakkumar; Min Yun, B.; Yoganathan, Ajit P.

    2014-01-01

    The hinge regions of the bileaflet mechanical heart valve (BMHV) can cause blood element damage due to nonphysiological shear stress levels and regions of flow stasis. Recently, a micro particle image velocimetry (μPIV) system was developed to study whole flow fields within BMHV hinge regions with enhanced spatial resolution under steady leakage flow conditions. However, global velocity maps under pulsatile conditions are still necessary to fully understand the blood damage potential of these...

  16. Are the Current Doppler Echocardiography Criteria Able to Discriminate Mitral Bileaflet Mechanical Heart Valve Malfunction? An In Vitro Study.

    Science.gov (United States)

    Evin, Morgane; Guivier-Curien, Carine; Pibarot, Philippe; Kadem, Lyes; Rieu, Régis

    2016-05-01

    Malfunction of bileaflet mechanical heart valves in the mitral position could either be due to patient-prosthesis mismatch (PPM) or leaflet obstruction. The aim of this article is to investigate the validity of current echocardiographic criteria used for diagnosis of mitral prosthesis malfunction, namely maximum velocity, mean transvalvular pressure gradient, effective orifice area, and Doppler velocity index. In vitro testing was performed on a double activation left heart duplicator. Both PPM and leaflet obstruction were investigated on a St. Jude Medical Master. PPM was studied by varying the St. Jude prosthesis size (21, 25, and 29 mm) and stroke volume (70 and 90 mL). Prosthesis leaflet obstruction was studied by partially or totally blocking the movement of one valve leaflet. Mitral flow conditions were altered in terms of E/A ratios (0.5, 1.0, and 1.5) to simulate physiologic panel of diastolic function. Maximum velocity, effective orifice area, and Doppler velocity index are shown to be insufficient to distinguish normal from malfunctioning St. Jude prostheses. Doppler velocity index and effective orifice area were 1.3 ± 0.49 and 1.83 ± 0.43 cm(2) for testing conditions with no malfunction below the 2.2 and 2 cm(2) thresholds (1.19 cm(2) for severe PPM and 1.23 cm(2) for fully blocked leaflet). The mean pressure gradient reached 5 mm Hg thresholds for several conditions of severe PPM only (6.9 mm Hg and mean maximum velocity value: 183.4 cm/s) whereas such value was never attained in the case of leaflet obstruction. In the case of leaflet obstruction, the maximum velocity averaged over the nine pulsed-wave Doppler locations increased by 38% for partial leaflet obstruction and 75% for a fully blocked leaflet when compared with normal conditions. Current echocardiographic criteria might be suboptimal for the detection of bileaflet mechanical heart valve malfunction. Further developments and investigations are required in order

  17. A NUMERICAL ANALYSIS OF THE BLOOD FLOW AROUND THE BILEAFLET MECHANICAL HEART VALVES WITH DIFFERENT ROTATIONAL IMPLANTATION ANGLES

    Institute of Scientific and Technical Information of China (English)

    HONG Taehyup; KIM Chang Nyung

    2011-01-01

    The effects of implantation angles of Bileaflet Mechanical Heart Valves (BMHVs) on the blood flow and the leaflet motion are investigated in this paper.The physiological blood flow interacting with the moving leaflets ofa BMHV is simulated with a strongly coupled implicit Fluid-Structure Interaction (FSI) method based on the Arbitrary-Lagrangian-Eulerian (ALE) approach and the dynamic mesh method (remeshing) in Fluent.BMHVs are widely used to be implanted to replace the diseascd heart valves,but the patients would suffer from some complications such as hemolysis,platelet activation,tissue overgrowth and device failure.These complications are closely related to both the flow characteristics near the valves and the leaflet dynamics.The currentnumerical model is validated against a previous experimental study.The numerical results show that as the rotation angle of BMHV is increased the degree of asymmetry of the blood flow and the leaflet motion is increased,which may lead to an unbalanced force acting on the BMHVs.This study shows the applicability of the FSI model for the interaction between the blood flow and the leaflet motion in BMHVs.

  18. Simulation of the three-dimensional hinge flow fields of a bileaflet mechanical heart valve under aortic conditions.

    Science.gov (United States)

    Simon, Hélène A; Ge, Liang; Borazjani, Iman; Sotiropoulos, Fotis; Yoganathan, Ajit P

    2010-03-01

    Thromboembolic complications of bileaflet mechanical heart valves (BMHV) are believed to be due to detrimental stresses imposed on blood elements by the hinge flows. Characterization of these flows is thus crucial to identify the underlying causes for complications. In this study, we conduct three-dimensional pulsatile flow simulations through the hinge of a BMHV under aortic conditions. Hinge and leaflet geometries are reconstructed from the Micro-Computed Tomography scans of a BMHV. Simulations are conducted using a Cartesian sharp-interface immersed-boundary methodology combined with a second-order accurate fractional-step method. Physiologic flow boundary conditions and leaflet motion are extracted from the Fluid-Structure Interaction simulations of the bulk of the flow through a BMHV. Calculations reveal the presence, throughout the cardiac cycle, of flow patterns known to be detrimental to blood elements. Flow fields are characterized by: (1) complex systolic flows, with rotating structures and slow reverse flow pattern, and (2) two strong diastolic leakage jets accompanied by fast reverse flow at the hinge bottom. Elevated shear stresses, up to 1920 dyn/cm2 during systole and 6115 dyn/cm2 during diastole, are reported. This study underscores the need to conduct three-dimensional simulations throughout the cardiac cycle to fully characterize the complexity and thromboembolic potential of the hinge flows. PMID:19960368

  19. Blood damage through a bileaflet mechanical heart valve: a quantitative computational study using a multiscale suspension flow solver.

    Science.gov (United States)

    Min Yun, B; Aidun, Cyrus K; Yoganathan, Ajit P

    2014-10-01

    Bileaflet mechanical heart valves (BMHVs) are among the most popular prostheses to replace defective native valves. However, complex flow phenomena caused by the prosthesis are thought to induce serious thromboembolic complications. This study aims at employing a novel multiscale numerical method that models realistic sized suspended platelets for assessing blood damage potential in flow through BMHVs. A previously validated lattice-Boltzmann method (LBM) is used to simulate pulsatile flow through a 23 mm St. Jude Medical (SJM) Regent™ valve in the aortic position at very high spatiotemporal resolution with the presence of thousands of suspended platelets. Platelet damage is modeled for both the systolic and diastolic phases of the cardiac cycle. No platelets exceed activation thresholds for any of the simulations. Platelet damage is determined to be particularly high for suspended elements trapped in recirculation zones, which suggests a shift of focus in blood damage studies away from instantaneous flow fields and toward high flow mixing regions. In the diastolic phase, leakage flow through the b-datum gap is shown to cause highest damage to platelets. This multiscale numerical method may be used as a generic solver for evaluating blood damage in other cardiovascular flows and devices. PMID:25070372

  20. Computational simulations of flow dynamics and blood damage through a bileaflet mechanical heart valve scaled to pediatric size and flow.

    Science.gov (United States)

    Yun, B Min; McElhinney, Doff B; Arjunon, Shiva; Mirabella, Lucia; Aidun, Cyrus K; Yoganathan, Ajit P

    2014-09-22

    Despite pressing needs, there are currently no FDA approved prosthetic valves available for use in the pediatric population. This study is performed for predictive assessment of blood damage in bileaflet mechanical heart valves (BMHVs) with pediatric sizing and flow conditions. A model of an adult-sized 23 mm St. Jude Medical (SJM) Regent(™) valve is selected for use in simulations, which is scaled in size for a 5-year old child and 6-month old infant. A previously validated lattice-Boltzmann method (LBM) is used to simulate pulsatile flow with thousands of suspended platelets for cases of adult, child, and infant BMHV flows. Adult BMHV flows demonstrate more disorganized small-scale flow features, but pediatric flows are associated with higher fluid shear stresses. Platelet damage in the pediatric cases is higher than in adult flow, highlighting thrombus complication dangers of pediatric BMHV flows. This does not necessarily suggest clinically important differences in thromboembolic potential. Highly damaged platelets in pediatric flows are primarily found far downstream of the valve, as there is less flow recirculation in pediatric flows. In addition, damage levels are well below expected thresholds for platelet activation. The extent of differences here documented between the pediatric and adult cases is of concern, demanding particular attention when pediatric valves are designed and manufactured. However, the differences between the pediatric and adult cases are not such that development of pediatric sized valves is untenable. This study may push for eventual approval of prosthetic valves resized for the pediatric population. Further studies will be necessary to determine the validity and potential thrombotic and clinical implications of these findings. PMID:25011622

  1. A numerical analysis on the curved bileaflet Mechanical Heart Valve (MHV) : leaflet motion and blood flow in an elastic blood vessel

    International Nuclear Information System (INIS)

    In blood flow passing through the Mechanical Heart Valve (MHV) and elastic blood vessel, hemolysis and platelet activation causing thrombus formation can be seen owing to the shear stress in the blood. Also, fracture and deformation of leaflets can be observed depending on the shape and material properties of the leaflets which is opened and closed in a cycle. Hence, comprehensive study is needed on the hemodynamics which is associated with the motion of leaflet and elastic blood vessel in terms of fluid-structure interaction. In this paper, a numerical analysis has been performed for a three-dimensional pulsatile blood flow associated with the elastic blood vessel and curved bileaflet for multiple cycles in light of fluid-structure interaction. From this analysis fluttering phenomenon and rebound of the leaflet have been observed and recirculation and regurgitation have been found in the flow fields of the blood. Also, the pressure distribution and the radial displacement of the elastic blood vessel have been obtained. The motion of the leaflet and flow fields of the blood have shown similar tendency compared with the previous experiments carried out in other studies. The present study can contribute to the design methodology for the curved bileaflet mechanical heart valve. Furthermore, the proposed fluid-structure interaction method will be effectively used in various fields where the interaction between fluid flow and structure are involved

  2. Computational Simulation of Blood Flow through Bileaflet Heart Valve Prostheses

    Science.gov (United States)

    Healy, Timothy; Sotiropoulos, Fotis; Yoganathan, Ajit

    2001-11-01

    Non-physiologic flow patterns and levels of turbulence caused by contemporary bileaflet mechanical heart valve (MHV) designs are believed to be partially responsible for thromboembolic complications caused by these valves. Presently, computer-based flow assessment is not employed as a design tool. Rather, CFD is used to understand flow dynamics under highly-specialized circumstances after a design has been selected and tested experimentally. The absence of CFD from the design-screening process is most likely due to undeveloped tools specific to the heart valve problem. CFD tools for assessing MHV flow performance should be efficient at simulating the fluid-structure interaction and the resulting leaflet motion. As the first stage in the development of MHV simulation tools, a high-accuracy Chimera solver was developed and tested for laminar flow through two bileaflet MHV designs. Steady and time-dependent simulations were performed providing the highest resolution simulations of three-dimensional MHV flow fields to date. Flow structures and time-dependent flow phenomena were investigated and interpreted in the context of the clinical performance of each design studied.

  3. CFD simulation of a novel bileaflet mechanical heart valve prosthesis: an estimation of the Venturi passage formed by the leaflets.

    Science.gov (United States)

    Yokoyama, Y; Medart, D; Hormes, M; Schmitz, C; Hamilton, K; Kwant, P B; Takatani, S; Schmitz-Rode, T; Steinseifer, U

    2006-12-01

    The aim of this study was to validate the flow characteristics of the novel Helmholtz-Institute Aachen Bileaflet (HIA-BL) heart valve prosthesis. The curved leaflets of the HIA-BL valve form a Venturi passage between the leaflets at peak systole. By narrowing the cross section the flow accelerates and the static pressure at the central passage decreases according to the Venturi effect. The low-pressure zone between the leaflets is expected to stabilize the leaflets in fully open position at peak systole. To investigate the Venturi passage, the flow fields of two valve geometries were investigated by CFD (Computational Fluid Dynamics): one geometry exhibits curved leaflets resulting in a Venturi passage; the other geometry features straight leaflets. The flow profiles, pressure distribution and resulting torque of both passages were compared and investigated. Although flow profiles downstream of both valves were similar, the flow passages between the leaflets were different for the investigated leaflet geometries. The straight leaflet passage showed a large boundary layer separation zone near the leaflets and the lowest pressure at the leading edge of the leaflet. The Venturi passage showed a reduction of the boundary layer separation zones and the lowest pressure between the leaflets could be found in the narrowest flow cross section of the Venturi passage. Additionally, the resulting torque showed that the Venturi passage produced an opening momentum. The results demonstrate that the Venturi passage stabilizes the leaflets in open position at peak systole. PMID:17219353

  4. Particle Image Velocimetry Study of Pulsatile Flow in Bi-leaflet Mechanical Heart Valves with Image Compensation Method

    OpenAIRE

    Shi, Yubing; Yeo, Tony Joon Hock; Zhao, Yong; Hwang, Ned H. C.

    2006-01-01

    Particle Image Velocimetry (PIV) is an important technique in studying blood flow in heart valves. Previous PIV studies of flow around prosthetic heart valves had different research concentrations, and thus never provided the physical flow field pictures in a complete heart cycle, which compromised their pertinence for a better understanding of the valvular mechanism. In this study, a digital PIV (DPIV) investigation was carried out with improved accuracy, to analyse the pulsatile flow field ...

  5. Effect of hinge gap width of a St. Jude medical bileaflet mechanical heart valve on blood damage potential--an in vitro micro particle image velocimetry study.

    Science.gov (United States)

    Jun, Brian H; Saikrishnan, Neelakantan; Arjunon, Sivakkumar; Yun, B Min; Yoganathan, Ajit P

    2014-09-01

    The hinge regions of the bileaflet mechanical heart valve (BMHV) can cause blood element damage due to nonphysiological shear stress levels and regions of flow stasis. Recently, a micro particle image velocimetry (μPIV) system was developed to study whole flow fields within BMHV hinge regions with enhanced spatial resolution under steady leakage flow conditions. However, global velocity maps under pulsatile conditions are still necessary to fully understand the blood damage potential of these valves. The current study hypothesized that the hinge gap width will affect flow fields in the hinge region. Accordingly, the blood damage potential of three St. Jude Medical (SJM) BMHVs with different hinge gap widths was investigated under pulsatile flow conditions, using a μPIV system. The results demonstrated that the hinge gap width had a significant influence during the leakage flow phase in terms of washout and shear stress characteristics. During the leakage flow, the largest hinge gap generated the highest Reynolds shear stress (RSS) magnitudes (~1000 N/m²) among the three valves at the ventricular side of the hinge. At this location, all three valves indicated viscous shear stresses (VSS) greater than 30 N/m². The smallest hinge gap exhibited the lowest level of shear stress values, but had the poorest washout flow characteristics among the three valves, demonstrating propensity for flow stasis and associated activated platelet accumulation potential. The results from this study indicate that the hinge is a critical component of the BMHV design, which needs to be optimized to find the appropriate balance between reduction in fluid shear stresses and enhanced washout during leakage flow, to ensure minimal thrombotic complications.

  6. Effect of hinge gap width of a St. Jude medical bileaflet mechanical heart valve on blood damage potential--an in vitro micro particle image velocimetry study.

    Science.gov (United States)

    Jun, Brian H; Saikrishnan, Neelakantan; Arjunon, Sivakkumar; Yun, B Min; Yoganathan, Ajit P

    2014-09-01

    The hinge regions of the bileaflet mechanical heart valve (BMHV) can cause blood element damage due to nonphysiological shear stress levels and regions of flow stasis. Recently, a micro particle image velocimetry (μPIV) system was developed to study whole flow fields within BMHV hinge regions with enhanced spatial resolution under steady leakage flow conditions. However, global velocity maps under pulsatile conditions are still necessary to fully understand the blood damage potential of these valves. The current study hypothesized that the hinge gap width will affect flow fields in the hinge region. Accordingly, the blood damage potential of three St. Jude Medical (SJM) BMHVs with different hinge gap widths was investigated under pulsatile flow conditions, using a μPIV system. The results demonstrated that the hinge gap width had a significant influence during the leakage flow phase in terms of washout and shear stress characteristics. During the leakage flow, the largest hinge gap generated the highest Reynolds shear stress (RSS) magnitudes (~1000 N/m²) among the three valves at the ventricular side of the hinge. At this location, all three valves indicated viscous shear stresses (VSS) greater than 30 N/m². The smallest hinge gap exhibited the lowest level of shear stress values, but had the poorest washout flow characteristics among the three valves, demonstrating propensity for flow stasis and associated activated platelet accumulation potential. The results from this study indicate that the hinge is a critical component of the BMHV design, which needs to be optimized to find the appropriate balance between reduction in fluid shear stresses and enhanced washout during leakage flow, to ensure minimal thrombotic complications. PMID:24976188

  7. High-resolution fluid-structure interaction simulations of flow through a bi-leaflet mechanical heart valve in an anatomic aorta.

    Science.gov (United States)

    Borazjani, Iman; Ge, Liang; Sotiropoulos, Fotis

    2010-02-01

    We have performed high-resolution fluid-structure interaction simulations of physiologic pulsatile flow through a bi-leaflet mechanical heart valve (BMHV) in an anatomically realistic aorta. The results are compared with numerical simulations of the flow through an identical BMHV implanted in a straight aorta. The comparisons show that although some of the salient features of the flow remain the same, the aorta geometry can have a major effect on both the flow patterns and the motion of the valve leaflets. For the studied configuration, for instance, the BMHV leaflets in the anatomic aorta open much faster and undergo a greater rebound during closing than the same valve in the straight axisymmetric aorta. Even though the characteristic triple-jet structure does emerge downstream of the leaflets for both cases, for the anatomic case the leaflet jets spread laterally and diffuse much faster than in the straight aorta due to the aortic curvature and complex shape of the anatomic sinus. Consequently the leaflet shear layers in the anatomic case remain laminar and organized for a larger portion of the accelerating phase as compared to the shear layers in the straight aorta, which begin to undergo laminar instabilities well before peak systole is reached. For both cases, however, the flow undergoes a very similar explosive transition to the small-scale, turbulent-like state just prior to reaching peak systole. The local maximum shear stress is used as a metric to characterize the mechanical environment experienced by blood cells. Pockets of high local maximum shear are found to be significantly more widespread in the anatomic aorta than in the straight aorta throughout the cardiac cycle. Pockets of high local maximum shear were located near the leaflets and in the aortic arc region. This work clearly demonstrates the importance of the aortic geometry on the flow phenomena in a BMHV and demonstrates the potential of our computational method to carry out image

  8. Laser Doppler anemometry measurements of steady flow through two bi-leaflet prosthetic heart valves

    Directory of Open Access Journals (Sweden)

    Ovandir Bazan

    2013-12-01

    Full Text Available INTRODUCTION: In vitro hydrodynamic characterization of prosthetic heart valves provides important information regarding their operation, especially if performed by noninvasive techniques of anemometry. Once velocity profiles for each valve are provided, it is possible to compare them in terms of hydrodynamic performance. In this first experimental study using laser doppler anemometry with mechanical valves, the simulations were performed at a steady flow workbench. OBJECTIVE: To compare unidimensional velocity profiles at the central plane of two bi-leaflet aortic prosthesis from St. Jude (AGN 21 - 751 and 21 AJ - 501 models exposed to a steady flow regime, on four distinct sections, three downstream and one upstream. METHODS: To provide similar conditions for the flow through each prosthesis by a steady flow workbench (water, flow rate of 17L/min. and, for the same sections and sweeps, to obtain the velocity profiles of each heart valve by unidimensional measurements. RESULTS: It was found that higher velocities correspond to the prosthesis with smaller inner diameter and instabilities of flow are larger as the section of interest is closer to the valve. Regions of recirculation, stagnation of flow, low pressure, and flow peak velocities were also found. CONCLUSIONS: Considering the hydrodynamic aspect and for every section measured, it could be concluded that the prosthesis model AGN 21 - 751 (RegentTM is superior to the 21 AJ - 501 model (Master Series. Based on the results, future studies can choose to focus on specific regions of the these valves.

  9. Hemodynamic Flow Characterization of St. Jude Medical Bileaflet Mechanical and Bioprosthetic Heart Valve Prostheses in a Left Ventricular Model via Digital Particle Image Velocimetry

    OpenAIRE

    Pierrakos, Olga

    2002-01-01

    The performance of the heart after a valve replacement operation will greatly depend on the flow character downstream the mitral valve thus a better understanding of the flow character is essential. Most in vitro studies of the flow downstream of a MHV have been conducted with the valve in the aortic position. Researchers reported detailed measurements most of which were obtained by Laser Doppler Velocimetry (LDV) in rigid models of the aorta. Digital Particle Image Velocimetry (DPIV) has a...

  10. The Measurement of Opening Angle and Orifice Area of a Bileaflet Mechanical Valve Using Multidetector Computed Tomography

    OpenAIRE

    Lee, Dong-Hyeon; Youn, Ho-Joong; Shim, Sung-Bo; Lee, Sun-Hee; Jung, Jung-Im; Jung, Seung-Eun; Choi, Yun-Seok; Park, Chul-Soo; Oh, Yong-Seog; Chung, Wook-Sung; Kim, Jae-Hyung

    2009-01-01

    Background and Objectives The aim of this study was to assess mechanical valve function using 64-slice multidetector computed tomography (MDCT). Subjects and Methods In 20 patients (mean age, 50±12 years; male-to-female ratio, 10:10), 30 St. Jude bileaflet mechanical valves (15 aortic and 15 mitral valves) were evaluated using MDCT. We selected images vertical and parallel to the mechanical valve. The valve orifice area (OA) and valve length were determined by manual tracing and the opening a...

  11. Laser Doppler anemometry measurements of steady flow through two bi-leaflet prosthetic heart valves

    OpenAIRE

    Ovandir Bazan; Jayme Pinto Ortiz; Francisco Ubaldo Vieira Junior; Reinaldo Wilson Vieira; Nilson Antunes; Fabio Bittencourt Dutra Tabacow; Eduardo Tavares Costa; Orlando Petrucci Junior

    2013-01-01

    INTRODUCTION: In vitro hydrodynamic characterization of prosthetic heart valves provides important information regarding their operation, especially if performed by noninvasive techniques of anemometry. Once velocity profiles for each valve are provided, it is possible to compare them in terms of hydrodynamic performance. In this first experimental study using laser doppler anemometry with mechanical valves, the simulations were performed at a steady flow workbench. OBJECTIVE: To compare unid...

  12. Motion analysis of mechanical heart valve prosthesis utilizing high-speed video

    Science.gov (United States)

    Adlparvar, Payam; Guo, George; Kingsbury, Chris

    1993-01-01

    The Edwards-Duromedics (ED) mechanical heart valve prosthesis is of a bileaflet design, incorporating unique design features that distinguish its performance with respect to other mechanical valves of similar type. Leaflet motion of mechanical heart valves, particularly during closure, is related to valve durability, valve sounds and the efficiency of the cardiac output. Modifications to the ED valve have resulted in significant improvements with respect to leaflet motion. In this study a high-speed video system was used to monitor the leaflet motion of the valve, and to compare the performance of the Modified Specification to that of the Original Specification using a St. Jude Medical as a control valve.

  13. Micro Particle Image Velocimetry Measurements of Steady Diastolic Leakage Flow in the Hinge of a St. Jude Medical® Regent™ Mechanical Heart Valve

    OpenAIRE

    Jun, Brian H.; Saikrishnan, Neelakantan; Yoganathan, Ajit P.

    2013-01-01

    A number of clinical, in vitro and computational studies have shown the potential for thromboembolic complications in bileaflet mechanical heart valves (BMHV), primarily due to the complex and unsteady flows in the valve hinges. These studies have focused on quantitative and qualitative parameters such as velocity magnitude, turbulent shear stresses, vortex formation and platelet activation to identify potential for blood damage. However, experimental characterization of the whole flow fields...

  14. Development of an Animal Experimental Model for a Bileaflet Mechanical Heart Valve Prosthesis

    OpenAIRE

    Choo, Suk Jung; Kim, Kun Il; Park, Nam Hee; Song, Jong Min; Choi, In Cheol; Shim, Jee Yeon; Lee, Sang Kwon; Kwon, Young Joo; Kim, Chang Nyung; Lee, Jae Won

    2004-01-01

    The objective of this study was to develop a pre-clinical large animal model for the in vivo hemodynamic testing of prosthetic valves in the aortic position without the need for cardiopulmonary bypass. Ten male pigs were used. A composite valved conduit was constructed in the operating room by implanting a prosthetic valve between two separate pieces of vascular conduits, which bypassed the ascending aorta to the descending aorta. Prior to applying a side-biting clamp to the ascending aorta f...

  15. Two-dimensional FSI simulation of closing dynamics of a tilting disc mechanical heart valve.

    Science.gov (United States)

    Govindarajan, V; Udaykumar, H S; Herbertson, L H; Deutsch, S; Manning, K B; Chandran, K B

    2010-03-01

    The fluid dynamics during valve closure resulting in high shear flows and large residence times of particles has been implicated in platelet activation and thrombus formation in mechanical heart valves. Our previous studies with bi-leaflet valves have shown that large shear stresses induced in the gap between the leaflet edge and the valve housing results in relatively high platelet activation levels whereas flow between the leaflets results in shed vortices not conducive to platelet damage. In this study we compare the result of closing dynamics of a tilting disc valve with that of a bi-leaflet valve. The two-dimensional fluid-structure interaction analysis of a tilting disc valve closure mechanics is performed with a fixed grid Cartesian mesh flow solver with local mesh refinement, and a Lagrangian particle dynamic analysis for computation of potential for platelet activation. Throughout the simulation the flow remains in the laminar regime and the flow through the gap width is marked by the development of a shear layer which separates from the leaflet downstream of the valve. Zones of re-circulation are observed in the gap between the leaflet edge and the valve housing on the major orifice region of the tilting disc valve and are seen to be migrating towards the minor orifice region. Jet flow is observed at the minor orifice region and a vortex is formed which sheds in the direction of fluid motion as observed in experiments using PIV measurements. The activation parameter computed for the tilting disc valve, at the time of closure was found to be 2.7 times greater than that of the bi-leaflet mechanical valve and was found to be in the vicinity of the minor orifice region mainly due to the migration of vortical structures from the major to the minor orifice region during the leaflet rebound of the closing phase.

  16. Mechanism of artificial heart

    CERN Document Server

    Yamane, Takashi

    2016-01-01

    This book first describes medical devices in relation to regenerative medicine before turning to a more specific topic: artificial heart technologies. Not only the pump mechanisms but also the bearing, motor mechanisms, and materials are described, including expert information. Design methods are described to enhance hemocompatibility: main concerns are reduction of blood cell damage and protein break, as well as prevention of blood clotting. Regulatory science from R&D to clinical trials is also discussed to verify the safety and efficacy of the devices.

  17. A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns

    OpenAIRE

    Sean Guo-Dong Tan; Sangho Kim; Jimmy Kim Fatt Hon; Hwa Liang Leo

    2016-01-01

    Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry...

  18. Developments in mechanical heart valve prosthesis

    Indian Academy of Sciences (India)

    Kalyani Nair; C V Muraleedharan; G S Bhuvaneshwar

    2003-06-01

    Artificial heart valves are engineered devices used for replacing diseased or damaged natural valves of the heart. Most commonly used for replacement are mechanical heart valves and biological valves. This paper briefly outlines the evolution, designs employed, materials being used,. and important factors that affect the performance of mechanical heart valves. The clinical performance of mechanical heart valves is also addressed. Efforts made in India in the development of mechanical heart valves are also discussed.

  19. A biomimetic bi-leaflet mitral prosthesis with enhanced physiological left ventricular swirl restorative capability

    Science.gov (United States)

    Tan, Sean Guo-Dong; Kim, Sangho; Leo, Hwa Liang

    2016-06-01

    Mechanical heart valve prostheses are often implanted in young patients due to their durability and long-term reliability. However, existing designs are known to induce elevated levels of blood damage and blood platelet activation. As a result, there is a need for patients to undergo chronic anti-coagulation treatment to prevent thrombosis, often resulting in bleeding complications. Furthermore, recent studies have suggested that the implantation of a mechanical prosthetic valve at the mitral position results in a significant alteration of the left ventricular flow field which may contribute to flow turbulence. This study proposes a bi-leaflet mechanical heart valve design (Bio-MHV) that mimics the geometry of a human mitral valve, with the aim of reducing turbulence levels in the left ventricle by replicating physiological flow patterns. An in vitro three-dimensional particle velocimetry imaging experiment was carried out to compare the hemodynamic performance of the Bio-MHV with that of the clinically established ATS valve. The Bio-MHV was found to replicate physiological left ventricular flow patterns and produced lower turbulence levels.

  20. Numerical simulation of flow in mechanical heart valves: grid resolution and the assumption of flow symmetry.

    Science.gov (United States)

    Ge, Liang; Jones, S Casey; Sotiropoulos, Fotis; Healy, Timothy M; Yoganathan, Ajit P

    2003-10-01

    A numerical method is developed for simulating unsteady, 3-D, laminar flow through a bileaflet mechanical heart valve with the leaflets fixed. The method employs a dual-time-stepping artificial-compressibility approach together with overset (Chimera) grids and is second-order accurate in space and time. Calculations are carried out for the full 3-D valve geometry under steady inflow conditions on meshes with a total number of nodes ranging from 4 x 10(5) to 1.6 x 10(6). The computed results show that downstream of the leaflets the flow is dominated by two pairs of counter-rotating vortices, which originate on either side of the central orifice in the aortic sinus and rotate such that the common flow of each pair is directed away from the aortic wall. These vortices intensify with Reynolds number, and at a Reynolds number of approximately 1200 their complex interaction leads to the onset of unsteady flow and the break of symmetry with respect to both geometric planes of symmetry. Our results show the highly 3-D structure of the flow; question the validity of computationally expedient assumptions of flow symmetry; and demonstrate the need for highly resolved, fully 3-D simulations if computational fluid dynamics is to accurately predict the flow in prosthetic mechanical heart valves.

  1. Mechanisms of heart failure in obesity.

    Science.gov (United States)

    Ebong, Imo A; Goff, David C; Rodriguez, Carlos J; Chen, Haiying; Bertoni, Alain G

    2014-01-01

    Heart failure is a leading cause of morbidity and mortality and its prevalence continues to rise. Because obesity has been linked with heart failure, the increasing prevalence of obesity may presage further rise in heart failure in the future. Obesity-related factors are estimated to cause 11% of heart failure cases in men and 14% in women. Obesity may result in heart failure by inducing haemodynamic and myocardial changes that lead to cardiac dysfunction, or due to an increased predisposition to other heart failure risk factors. Direct cardiac lipotoxicity has been described where lipid accumulation in the heart results in cardiac dysfunction inexplicable of other heart failure risk factors. In this overview, we discussed various pathophysiological mechanisms that could lead to heart failure in obesity, including the molecular mechanisms underlying cardiac lipotoxicity. We defined the obesity paradox and enumerated various premises for the paradoxical associations observed in the relationship between obesity and heart failure.

  2. 国产人工机械瓣膜的历史与研究进展%History and Research Advance of China-made Mechanical Heart Valves

    Institute of Scientific and Technical Information of China (English)

    祁亮

    2013-01-01

    人工心脏瓣膜的应用至今已有50多年的历史,其中机械瓣膜在瓣膜病治疗中有着显著的临床疗效.回顾人工机械瓣膜的研究历史,大至经历了从第一代笼球瓣、笼碟瓣到第二代单叶侧倾碟瓣,再到第三代双叶机械瓣的发展过程.1960年国外首次应用笼球式机械瓣行心瓣膜置换术,我国在1963年也研制出了国产笼球瓣并应用于临床;1969年国外研制出第二代单叶侧倾碟瓣,国内于1978年研制出国产单叶侧倾碟瓣并广泛应用,取得了良好的临床疗效.从1980年双叶机械瓣问世至今,双叶瓣以优异的性能淘汰了以上两种瓣膜,成为当今的主流产品,而目前国内对双叶瓣的研发相对滞后,国内人工心脏瓣膜的市场也几乎被国外双叶瓣所垄断.因此,理想的人工心脏瓣膜有待国人继续研究开发.%Clinical application history of prosthetic heart valves has been over five decades, and mechanical heart valves have satisfactory clinical outcomes for surgical treatment of valvular heart disease. The development history of mechanical heart valves experienced from the first generation of ball valves and caged disc valves to the second generation of single tilting disc valve, and to the third generation of bileaflet valves. In 1960, ball valve was first used for heart valve replacement in abroad. In 1963, China-made ball valve was also produced and used in clinical practice. In 1969, the second generation of single tilting disc valve was developed in abroad. In 1978, China-made single tilting disc valve was produced and widely used in clinical practice with satisfactory clinical outcomes. Since 1980 when it was first produced, bileaflet valve has taken the place of above 2 types of valves for its excellent performance, and become the mainstream product all over the world. Currently, the development of China-made bileaflet valves has lagged behind, and domestic mechanical heart valve market has almost been

  3. 国产CL-V型双叶人工心脏瓣膜与进口St.Jude双叶瓣的临床疗效比较%Comparison on Clinical Outcomes Between China-made CL-V Bileaflet Prosthesis and St.Jude Bileaflet Prosthesis

    Institute of Scientific and Technical Information of China (English)

    祁亮; 宋兵; 刘瑞生; 唐汉博; 赵宏林; 邢旺; 高百顺

    2012-01-01

    Objective To evaluate early clinical outcomes and short-term follow-up results of CL-V bileaflet prosthesis. Methods From April 2004 to May 2010, 38 patients with valvular heart diseases underwent mechanical heart valve replacement. Eighteen patients received CL-V bileaflet valve replacement (CL group) including 8 males and 10 females with their mean age of (47. 4 ±6. 2) years and mean body weight off 64. 7±11. 9) kg. Preoperatively, 15 patients were in New York Heart Association (NYHA) class Ⅲ, and 2 patients were in NYHA class IV. Mitral valve replacement (MVR) was performed in 16patients, mitral and aortic valve replacement (DVR) in 2 patients. A total of 20 CL-V bileaflet prostheses were implanted. Twenty patients received St. Jude bileaflet valve replacement (SJM group Kncluding 9 males and 11 females with their mean age of (49. 7±7. 6) years and mean body weight of (66. 1±11. 1) kg. Preoperatively,15 patients were in NYHA class Ⅲ, and 3 patients were in NYHA class Ⅳ . MVR was performed in 17 patients, aortic valve replacement (AVR) in 1 patient, and DVR in 2 patients. A total of 22 St. Jude bileaflet prostheses were implanted. Clinical outcomes, hear function, hemodynamics and blood compatibility were measured on the 7th postoperative day and 6 months during follow-up and compared between the two groups. Results There was no early mortality ( < 30 d) or postoperative complication in either group. Follow-up rate was 100% and the mean follow-up duration was 19. 8 (6-61) months. At 6 months after surgery, those patients who were preoperatively in NYHA class Ⅲ or Ⅳall improved to class Ⅰ orⅡ. In CL group, cardiothoracic ratio was 0. 51±0. 05, left atrium diameter (44. 5±7. 8) mm, left ventricular end dias-tolic diameter (LVEDD, 46. 6±4.1) mm, LVEF 65. 3%±7. 7%, and LVFS 35. 0%±7. 1%. In SJM group, cardiothoracic ratio was 0. 51±0. 06, left atrium diameter(45. 8±9. 6)mm, LVEDD(46. 2±9. 8) mm, LVEF 64. l%+9. 0%, and LVFS 34. 9%±4. 7

  4. Aortic root compliance influences hemolysis in mechanical heart valve prostheses: an in-vitro study.

    Science.gov (United States)

    Linde, Torsten; Hamilton, Kathrin F; Navalon, Elena Cuenca; Schmitz-Rode, Thomas; Steinseifer, Ulrich

    2012-07-01

    Mechanical heart valve prostheses are known to activate coagulation and cause hemolysis. Both are particularly dependent on the leaflet dynamics, which in turn depends on the flow field in the aortic root influenced by the aortic root geometry and its compliance. Compliance reduction of large vessels occurs in aging patients, both in those who have atherosclerotic diseases and those who do not. In this study we investigated the correlation between hemolysis and the compliance of the proximal aorta in a novel, pulsatile in vitro blood tester using porcine blood. Two mechanical heart valves, the St Jude Medical (SJM) bileaflet valve and a trileaflet valve prototype (Triflo) were tested for hemolysis under physiological conditions (120/80 mm Hg, 4.5 l/min, 70 bpm) and using two different tester setups: with a stiff aorta and with a compliant aorta. Valve dynamics were subsequently analyzed via high-speed videos. In the tests with the Triflo valve, the free plasma hemoglobin increased by 13.4 mg/dl for the flexible and by 19.3 mg/dl for the stiff setup during the 3-hour test. The FFT spectra and closing speed showed slight differences for both setups. Free plasma hemoglobin for the SJM valve was up by 22.2 mg/dl in the flexible and 42.7 mg/dl in the stiff setup. Cavitation induced by the higher closing speed might be responsible for this, which is also indicated by the sound spectrum elevation above 16 kHz. PMID:22669587

  5. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

    Løgstrup, Brian B; Vase, Henrik; Gjedsted, Jakob;

    2016-01-01

    Heart failure is one of the most common causes of morbidity and mortality worldwide. When patients cease to respond adequately to optimal medical therapy mechanical circulatory support has been promising. The advent of mechanical circulatory support devices has allowed significant improvements...... in patient survival and quality of life for those with advanced or end-stage heart failure. We provide a general overview of current mechanical circulatory support devices encompassing options for both short- and long-term ventricular support....

  6. Tubular Heart Pumping Mechanisms in Ciona Intestinalis

    Science.gov (United States)

    Battista, Nicholas; Miller, Laura

    2015-11-01

    In vertebrate embryogenesis, the first organ to form is the heart, beginning as a primitive heart tube. However, many invertebrates have tubular hearts from infancy through adulthood. Heart tubes have been described as peristaltic and impedance pumps. Impedance pumping assumes a single actuation point of contraction, while traditional peristalsis assumes a traveling wave of actuation. In addition to differences in flow, this inherently implies differences in the conduction system. It is possible to transition from pumping mechanism to the other with a change in the diffusivity of the action potential. In this work we consider the coupling between the fluid dynamics and electrophysiology of both mechanisms, within a basal chordate, the tunicate. Using CFD with a neuro-mechanical model of tubular pumping, we discuss implications of the both mechanisms. Furthermore, we discuss the implications of the pumping mechanism on evolution and development.

  7. A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns.

    Directory of Open Access Journals (Sweden)

    Sean Guo-Dong Tan

    Full Text Available Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation.

  8. A D-Shaped Bileaflet Bioprosthesis which Replicates Physiological Left Ventricular Flow Patterns.

    Science.gov (United States)

    Tan, Sean Guo-Dong; Kim, Sangho; Hon, Jimmy Kim Fatt; Leo, Hwa Liang

    2016-01-01

    Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation. An in-vitro experiment using two dimensional particle velocimetry imaging was carried out to determine the hemodynamic performance of the new bileaflet design and then compared to that of the well-established St. Jude Epic valve which functioned as a control in the experiment. Although both valves were found to have similar Reynolds shear stress and Turbulent Kinetic Energy levels, the novel D-shape valve was found to have lower turbulence intensity and greater mean kinetic energy conservation. PMID:27258099

  9. Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

    OpenAIRE

    Symersky, P.; Budde, R. P. J.; Westers, P.; Mol, de, B.A.J.M.; Prokop, M

    2011-01-01

    Objectives Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. Methods A Medtronic Hall tilting disc (MH), and Carbomedics (CM), St Jude (SJM), and ON-X bileaflet valves underwent CT in an in-vitro model using retrospective gating with a 64 detector CT system in stati...

  10. Hydrogen peroxide primes heart regeneration with a derepression mechanism

    OpenAIRE

    Han, Peidong; Zhou, Xiao-Hai; Chang, Nannan; Xiao, Cheng-Lu; Yan, Shouyu; Ren, He; Yang, Xin-Zhuang; Zhang, Mei-Ling; Wu, Qing; Tang, Boyang; Diao, Ju-Peng; Zhu, Xiaojun; Zhang, Chuanmao; Li, Chuan-Yun; Cheng, Heping

    2014-01-01

    While the adult human heart has very limited regenerative potential, the adult zebrafish heart can fully regenerate after 20% ventricular resection. Although previous reports suggest that developmental signaling pathways such as FGF and PDGF are reused in adult heart regeneration, the underlying intracellular mechanisms remain largely unknown. Here we show that H2O2 acts as a novel epicardial and myocardial signal to prime the heart for regeneration in adult zebrafish. Live imaging of intact ...

  11. Cell death signalling mechanisms in heart failure

    OpenAIRE

    Mughal, Wajihah; Kirshenbaum, Lorrie A.

    2011-01-01

    In 2003, cardiovascular disease was the most costly disease in Canada, and it is still on the rise. The loss of properly functioning cardiomyocytes leads to cardiac impairment, which is a consequence of heart failure. Therefore, understanding the pathways of cell death (necrosis and apoptosis) has potential implications for the development of therapeutic strategies. In addition, the role of B-cell lymphoma-2 family members is discussed and the importance of mitochondria in directing cell deat...

  12. Mechanical stimulation in the engineering of heart muscle.

    Science.gov (United States)

    Liaw, Norman Yu; Zimmermann, Wolfram-Hubertus

    2016-01-15

    Recreating the beating heart in the laboratory continues to be a formidable bioengineering challenge. The fundamental feature of the heart is its pumping action, requiring considerable mechanical forces to compress a blood filled chamber with a defined in- and outlet. Ventricular output crucially depends on venous loading of the ventricles (preload) and on the force generated by the preloaded ventricles to overcome arterial blood pressure (afterload). The rate of contraction is controlled by the spontaneously active sinus node and transmission of its electrical impulses into the ventricles. The underlying principles for these physiological processes are described by the Frank-Starling mechanism and Bowditch phenomenon. It is essential to consider these principles in the design and evaluation of tissue engineered myocardium. This review focuses on current strategies to evoke mechanical loading in hydrogel-based heart muscle engineering.

  13. Micro particle image velocimetry measurements of steady diastolic leakage flow in the hinge of a St. Jude Medical® regent™ mechanical heart valve.

    Science.gov (United States)

    Jun, Brian H; Saikrishnan, Neelakantan; Yoganathan, Ajit P

    2014-03-01

    A number of clinical, in vitro and computational studies have shown the potential for thromboembolic complications in bileaflet mechanical heart valves (BMHV), primarily due to the complex and unsteady flows in the valve hinges. These studies have focused on quantitative and qualitative parameters such as velocity magnitude, turbulent shear stresses, vortex formation, and platelet activation to identify potential for blood damage. However, experimental characterization of the whole flow fields within the valve hinges has not yet been conducted. This information can be utilized to investigate instantaneous damage to blood elements and also to validate numerical studies focusing on the hinge's complex fluid dynamics. The objective of this study was therefore to develop a high-resolution imaging system to characterize the flow fields and global velocity maps in a BMHV hinge. In this study, the steady leakage hinge flow fields representing the diastolic phase during the cardiac cycle in a 23 mm St. Jude Medical regent BMHV in the aortic position were characterized using a two-dimensional micro particle image velocimetry system. Diastolic flow was simulated by imposing a static pressure head on the aortic side. Under these conditions, a reverse flow jet from the aortic to the ventricular side was observed with velocities in the range of 1.47-3.24 m/s, whereas low flow regions were observed on the ventricular side of the hinge with viscous shear stress magnitude up to 60 N/m². High velocities and viscous shearing may be associated with platelet activation and hemolysis, while low flow zones can cause thrombosis due to increased residence time in the hinge. Overall, this study provides a high spatial resolution experimental technique to map the fluid velocity in the BMHV hinge, which can be extended to investigate micron-scale flow domains in various prosthetic devices under different hemodynamic conditions.

  14. MECHANICAL HEART-VALVE PROSTHESES - SOUND LEVEL AND RELATED COMPLAINTS

    NARCIS (Netherlands)

    LAURENS, RRP; WIT, HP; EBELS, T

    1992-01-01

    In a randomised study, we investigated the sound production of mechanical heart valve prostheses and the complaints related to this sound. The CarboMedics, Bjork-Shiley monostrut and StJude Medical prostheses were compared. A-weighted levels of the pulse-like sound produced by the prosthesis were me

  15. Fluid Mechanics of Heart Valves and Their Replacements

    Science.gov (United States)

    Sotiropoulos, Fotis; Le, Trung Bao; Gilmanov, Anvar

    2016-01-01

    As the pulsatile cardiac blood flow drives the heart valve leaflets to open and close, the flow in the vicinity of the valve resembles a pulsed jet through a nonaxisymmetric orifice with a dynamically changing area. As a result, three-dimensional vortex rings with intricate topology emerge that interact with the complex cardiac anatomy and give rise to shear layers, regions of recirculation, and flow instabilities that could ultimately lead to transition to turbulence. Such complex flow patterns, which are inherently valve- and patient-specific, lead to mechanical forces at scales that can cause blood cell damage and thrombosis, increasing the likelihood of stroke, and can trigger the pathogenesis of various life-threatening valvular heart diseases. We summarize the current understanding of flow phenomena induced by heart valves, discuss their linkage with disease pathways, and emphasize the research advances required to translate in-depth understanding of valvular hemodynamics into effective patient therapies.

  16. Advances in understanding the mechanism of zebrafish heart regeneration

    Directory of Open Access Journals (Sweden)

    Kazu Kikuchi

    2014-11-01

    Full Text Available The adult mammalian heart was once believed to be a post-mitotic organ without any capacity for regeneration, but recent findings have challenged this dogma. A modified view assigns the mammalian heart a measurable capacity for regeneration throughout its lifetime, with the implication that endogenous regenerative capacity can be therapeutically stimulated in the injury setting. Although extremely limited in adult mammals, the natural capacity for organ regeneration is a conserved trait in certain vertebrates. Urodele amphibians and teleosts are well-known examples of such animals that can efficiently regenerate various organs including the heart as adults. By understanding how these animals regenerate a damaged heart, one might obtain valuable insights into how regeneration can be augmented in injured human hearts. Among the regenerative vertebrate models, the teleost zebrafish, Danio rerio, is arguably the best characterized with respect to cardiac regenerative responses. Knowledge is still limited, but a decade of research in this model has led to results that may help to understand how cardiac regeneration is naturally stimulated and maintained. This review surveys recent advances in the field and discusses current understanding of the endogenous mechanisms of cardiac regeneration in zebrafish.

  17. [History, present and future of biomaterials used for artificial heart valves].

    Science.gov (United States)

    Kostrzewa, Benita; Rybak, Zbigniew

    2013-01-01

    Artificial heart valves can be classified into mechanical and biological. We have three types of mechanical heart valves: caged ball, tilting disc and bileaflet. Mechanical heart valves are made from various materials. They may be produced from metals, ceramics and polymers, e.g.: stainless steel, titanium, silicone, pyrolytic carbon. Biological valves are made from synthetic components (e.g.: PTFE, Dacron) and materials of biological origin (e.g.: cow pericardium, pig heart valve). We have also identified transcatheter aortic valve implantation (TAVI). TAVI may be produced from metals, ceramics and polymers (e.g.: stainless steel, titanium, Dacron) and biological material (e.g.: pig heart valve). This paper describes advantages and disadvantages of different types of artificial heart valves. The lifespan of mechanical valves is 20-30 years and they can be used for patients of any age. Mechanical valves have also disadvantages--anticoagulants are required to prevent thrombosis. Biological valves are made from natural materials, so they do not require prolonged anticoagulation. Their lifetime is 10-15 years, so they are offered to patients over 40 years. Another problem is the occurrence of calcification.

  18. Listen to your heart

    OpenAIRE

    Iacopo Bertolozzi; Angelo Pucci; Pietro Amedeo Modesti

    2009-01-01

    A 61-year-old woman came to the Emergency Department of our Hospital for fatigue and breathlessness. She was discharged from the surgery ward 2 days before, after a subtotal colectomy for adenocarcinoma had been performed 10 days before. While explaining her history, she appeared very worried because of not hearing since the day before, the usual clicking noise of her mechanical mitral valve prosthesis. The metallic bileaflet-tilting—disk valve (St Jude Medical, Inc.) ...

  19. Ischemic preconditioning in immature hearts: mechanism and compatibility with cardioplegia

    Institute of Scientific and Technical Information of China (English)

    朱斌; 闵苏; 龙村; 叶铁虎

    2003-01-01

    Objective To investigate (1) whether ischemic preconditioning (IPC) could protect immature rabbit hearts against ischemia-reperfusion injury and (2) the role of KATP channel in the mechanism of myocardial protection. Since cardioplegia is a t raditional and effective cardioprotective measure in clinic, our study is also d esigned to probe the compatibility between IPC and cardioplegia.Results The recovery of CF, HR, LVDP and ±dp/dtmax in preconditioned hearts was b est am ong the four groups. The incidence of arrhythmia was low and less CK-MB leaked out in the IPC group. Myocardial ATP content was better preserved by IPC. Pre treatment with glibenclamide completely abolished the myocardial protection prov ided by IPC, but did not affect ischemia-reperfusion injury.Conclusions While applying cardioplegia, IPC provides significant cardioprotective effects. Activation of KATP channels is involved in the mechanism of IPC-produced cardioprotection.

  20. Cardiac crossroads: deciding between mechanical or bioprosthetic heart valve replacement

    Directory of Open Access Journals (Sweden)

    Maggie N Tillquist

    2011-02-01

    Full Text Available Maggie N Tillquist1, Thomas M Maddox21School of Medicine, University of Colorado Denver, Denver, CO, USA; 2VA Eastern Colorado Health Care System, and Department of Medicine (Cardiology, University of Colorado Denver, Denver, CO, USAAbstract: Nearly 15 million people in the United States suffer from either aortic or mitral valvular disease. For patients with severe and symptomatic valvular heart disease, valve replacement surgery improves morbidity and mortality outcomes. In 2009, 90,000 valve replacement surgeries were performed in the United States. This review evaluates the advantages and disadvantages of mechanical and bioprosthetic prosthetic heart valves as well as the factors for consideration in deciding the appropriate valve type for an individual patient. Although many caveats exist, the general recommendation is for patients younger than 60 to 65 years to receive mechanical valves due to the valve's longer durability and for patients older than 60 to 65 years to receive a bioprosthetic valve to avoid complications with anticoagulants. Situations that warrant special consideration include patient co-morbidities, the need for anticoagulation, and the potential for pregnancy. Once these characteristics have been considered, patients' values, anxieties, and expectations for their lifestyle and quality of life should be incorporated into final valve selection. Decision aids can be useful in integrating preferences in the valve decision. Finally, future directions in valve technology, anticoagulation, and medical decision-making are discussed.Keywords: prosthetic heart valves, patient preference, valve type, anticoagulant, structural valve deterioration 

  1. Temporary Percutaneous Mechanical Circulatory Support in Advanced Heart Failure.

    Science.gov (United States)

    Brown, Jessica L; Estep, Jerry D

    2016-07-01

    Cardiogenic shock is severe, refractory heart failure caused by significant myocardial dysfunction in the setting of adequate preload that is accompanied by systemic hypoperfusion. Progressive end-organ dysfunction is a hallmark of persistent cardiogenic shock and necessitates intervention to overcome altered hemodynamics and restore end-organ perfusion. Temporary percutaneous mechanical circulatory support is an established modality in the treatment of cardiogenic shock and is increasingly used in patients with cardiogenic shock as a bridge to recovery or further definitive therapy. This article reviews the current devices, their effects on left ventricular hemodynamics, and the evidence supporting their continued use. PMID:27371515

  2. Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

    Energy Technology Data Exchange (ETDEWEB)

    Symersky, Petr [Onze Lieve Vrouwe Gasthuis, Department of Cardiothoracic Surgery, Oosterpark 9, P.O box 95500, Amsterdam (Netherlands); Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Budde, Ricardo P.J. [University Medical Center, Department of Radiology, Utrecht (Netherlands); Westers, Paul [Julius Center for Health Sciences and Primary Care, Department of Biostatistics, Utrecht (Netherlands); Mol, Bas A.J.M. de [Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); University of Technology Eindhoven, Department of Biomedical Engineering, Eindhoven (Netherlands); Prokop, Mathias [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands)

    2011-10-15

    Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. A Medtronic Hall tilting disc (MH), and Carbomedics (CM), St Jude (SJM), and ON-X bileaflet valves underwent CT in an in-vitro model using retrospective gating with a 64 detector CT system in stationary and pulsatile conditions. Artifacts and radiopaque component volumes were quantified with thresholds based on surrounding structures and valvular components. Hypodense artifacts volumes (mm{sup 3}) were 1,029 {+-} 147, 535 {+-} 53, 371 {+-} 16, and 366 {+-} 18 for the SJM, MH, CM and ON-X valves (p < 0.001 except for the latter two valves p = 0.43). Hyperdense artifact volumes were 3,546 {+-} 141, 2,387 {+-} 103, 2,003 {+-} 102, and 3,033 {+-} 31 for the SJM, MH, CM and ON-X valve, respectively (all differences p < 0.001). Leaflet motion affected hypodense (F = 41.5, p < 0.001) and hyperdense artifacts (F = 53.7, p < 0.001). Closed and moving leaflets were associated with the least and the most artifacts respectively (p < 0.001, both artifact types). Both valve design and leaflet motion affect PHV-induced artifacts. Best imaging results may be expected for the CM valve during phases in which the leaflets are closed. (orig.)

  3. Mechanisms of Cardiotoxicity and the Development of Heart Failure.

    Science.gov (United States)

    Lee, Christopher S

    2015-12-01

    Cardiotoxicity is a broad term that refers to the negative effects of toxic substances on the heart. Cancer drugs can cause cardiotoxicity by effects on heart cells, thromboembolic events, and/or hypertension that can lead to heart failure. Rheumatoid arthritis biologics may interfere with ischemic preconditioning and cause/worsen heart failure. Long-term and heavy alcohol use can result in oxidative stress, apoptosis, and decreased contractile protein function. Cocaine use results in sympathetic nervous system stimulation of heart and smooth muscle cells and leads to cardiotoxicity and evolution of heart failure. The definition of cardiotoxicity is likely to evolve along with knowledge about detecting subclinical myocardial injury. PMID:26567492

  4. Chagas heart disease: pathophysiologic mechanisms, prognostic factors and risk stratification

    Directory of Open Access Journals (Sweden)

    Anis Rassi Jr

    2009-07-01

    Full Text Available Chagas heart disease (CHD results from infection with the protozoan parasite Trypanosoma cruzi and is the leading cause of infectious myocarditis worldwide. It poses a substantial public health burden due to high morbidity and mortality. CHD is also the most serious and frequent manifestation of chronic Chagas disease and appears in 20-40% of infected individuals between 10-30 years after the original acute infection. In recent decades, numerous clinical and experimental investigations have shown that a low-grade but incessant parasitism, along with an accompanying immunological response [either parasite-driven (most likely or autoimmune-mediated], plays an important role in producing myocardial damage in CHD. At the same time, primary neuronal damage and microvascular dysfunction have been described as ancillary pathogenic mechanisms. Conduction system disturbances, atrial and ventricular arrhythmias, congestive heart failure, systemic and pulmonary thromboembolism and sudden cardiac death are the most common clinical manifestations of chronic Chagas cardiomyopathy. Management of CHD aims to relieve symptoms, identify markers of unfavourable prognosis and treat those individuals at increased risk of disease progression or death. This article reviews the pathophysiology of myocardial damage, discusses the value of current risk stratification models and proposes an algorithm to guide mortality risk assessment and therapeutic decision-making in patients with CHD.

  5. Radiation-Induced Heart Disease: Pathologic Abnormalities and Putative Mechanisms

    Directory of Open Access Journals (Sweden)

    Neil K Taunk

    2015-02-01

    Full Text Available Breast cancer is a common diagnosis in women. Breast radiation has become a critical in managing patients who receive breast conserving surgery, or have certain high-risk features after mastectomy. Most patients have an excellent prognosis, therefore understanding the late effects of radiation to the chest is important. Radiation induced heart disease (RIHD comprises a spectrum of cardiac pathology including myocardial fibrosis and cardiomyopathy, coronary artery disease, valvular disease, pericardial disease, and arrhythmias. Tissue fibrosis is a common mediator in RIHD. Multiple pathways converge with both acute and chronic cellular, molecular, and genetic changes to result in fibrosis. In this article, we review the pathophysiology of cardiac disease related to radiation therapy to the chest. Our understanding of these mechanisms has improved substantially, but much work remains to further refine radiation delivery techniques and develop therapeutics to battle late effects of radiation.

  6. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model

    Energy Technology Data Exchange (ETDEWEB)

    Dou Jianhong; Xia Ling; Zhang Yu; Shou Guofa [Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027 (China); Wei Qing; Liu Feng; Crozier, Stuart [School of Information Technology and Electrical Engineering, University of Queensland, St Lucia, Brisbane, Queensland 4072 (Australia)], E-mail: xialing@zju.edu.cn

    2009-01-21

    Asynchronous electrical activation, induced by bundle branch block (BBB), can cause reduced ventricular function. However, the effects of BBB on the mechanical function of heart are difficult to assess experimentally. Many heart models have been developed to investigate cardiac properties during BBB but have mainly focused on the electrophysiological properties. To date, the mechanical function of BBB has not been well investigated. Based on a three-dimensional electromechanical canine heart model, the mechanical properties of complete left and right bundle branch block (LBBB and RBBB) were simulated. The anatomical model as well as the fiber orientations of a dog heart was reconstructed from magnetic resonance imaging (MRI) and diffusion tensor MRI (DT-MRI). Using the solutions of reaction-diffusion equations and with a strategy of parallel computation, the asynchronous excitation propagation and intraventricular conduction in BBB was simulated. The mechanics of myocardial tissues were computed with time-, sarcomere length-dependent uniaxial active stress initiated at the time of depolarization. The quantification of mechanical intra- and interventricular asynchrony of BBB was then investigated using the finite-element method with an eight-node isoparametric element. The simulation results show that (1) there exists inter- and intraventricular systolic dyssynchrony during BBB; (2) RBBB may have more mechanical synchrony and better systolic function of the left ventricle (LV) than LBBB; (3) the ventricles always move toward the early-activated ventricle; and (4) the septum experiences higher stress than left and right ventricular free walls in BBB. The simulation results validate clinical and experimental recordings of heart deformation and provide regional quantitative estimates of ventricular wall strain and stress. The present work suggests that an electromechanical heart model, incorporating real geometry and fiber orientations, may be helpful for better

  7. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model

    Science.gov (United States)

    Dou, Jianhong; Xia, Ling; Zhang, Yu; Shou, Guofa; Wei, Qing; Liu, Feng; Crozier, Stuart

    2009-01-01

    Asynchronous electrical activation, induced by bundle branch block (BBB), can cause reduced ventricular function. However, the effects of BBB on the mechanical function of heart are difficult to assess experimentally. Many heart models have been developed to investigate cardiac properties during BBB but have mainly focused on the electrophysiological properties. To date, the mechanical function of BBB has not been well investigated. Based on a three-dimensional electromechanical canine heart model, the mechanical properties of complete left and right bundle branch block (LBBB and RBBB) were simulated. The anatomical model as well as the fiber orientations of a dog heart was reconstructed from magnetic resonance imaging (MRI) and diffusion tensor MRI (DT-MRI). Using the solutions of reaction-diffusion equations and with a strategy of parallel computation, the asynchronous excitation propagation and intraventricular conduction in BBB was simulated. The mechanics of myocardial tissues were computed with time-, sarcomere length-dependent uniaxial active stress initiated at the time of depolarization. The quantification of mechanical intra- and interventricular asynchrony of BBB was then investigated using the finite-element method with an eight-node isoparametric element. The simulation results show that (1) there exists inter- and intraventricular systolic dyssynchrony during BBB; (2) RBBB may have more mechanical synchrony and better systolic function of the left ventricle (LV) than LBBB; (3) the ventricles always move toward the early-activated ventricle; and (4) the septum experiences higher stress than left and right ventricular free walls in BBB. The simulation results validate clinical and experimental recordings of heart deformation and provide regional quantitative estimates of ventricular wall strain and stress. The present work suggests that an electromechanical heart model, incorporating real geometry and fiber orientations, may be helpful for better

  8. The mechanisms of muscle wasting in COPD and heart failure

    Directory of Open Access Journals (Sweden)

    Giorgio Vescovo

    2012-10-01

    Full Text Available Many of the mechanisms leading to skeletal muscle wasting in COPD and heart failure are common to both conditions. These encompass neurohormonal activation and systemic inflammation. The mechanisms leading to muscle dysfunction are both qualitative and quantitative. Qualitative changes comprise the transition from aerobic metabolism and prevalent slow fibers composition toward anaerobic metabolism and fast fibers synthesis. Quantitative changes are mainly linked to muscle loss. These changes occur not only in the major muscles bulks of the body but also in respiratory muscles. The mechanisms leading to muscle wastage include cytokine-triggered skeletal muscle apoptosis and ubiquitin-proteasomeand non-ubiquitin-dependent pathways. The regulation of fiber type involves the growth hormone/insulin-like growth factor 1/calcineurin/transcriptional coactivator PGC1 cascade. The imbalance between protein synthesis and degradation plays an important role. Protein degradation can occur through ubiquitin-dependent and non-ubiquitin-dependent pathways. Very recently, two systems controlling ubiquitin-proteasome activation have been described: FOXO-ubiquitin ligase and NFkB ubiquitin ligase. These are triggered by TNFα and growth hormone/insulin-like growth factor 1. Moreover, apoptosis, which is triggered by tumor necrosis factor α, plays an important role. Another mechanism acting on muscle wastage is malnutrition, with an imbalance between catabolic and anabolic factors toward the catabolic component. Catabolism is also worsened by the activation of the adrenergic system and alteration of the cortisol/DEHA ratio toward cortisol production. Sarcomeric protein oxidation and its consequent contractile impairment can be another cause of skeletal muscle dysfunction in CHF.

  9. Flow field analysis of mechanical heart valves. Comparison of Starr-Edwards, Bjork-Shiley c-c, and St. Jude medical prostheses; Kikaiteki jinkoben no nagareba no kaiseki. Starr-Edwards, Bjork-Shiley c-c, oyobi St. Jude Medical ben no hikaku

    Energy Technology Data Exchange (ETDEWEB)

    Akutsu, T. [Kanto Gakuin University, Yokohama (Japan); Bishop, W. [Andronic Inc., Richmond, BC, (Canada); Modi, V. [University of British Columbia, Vancouver, BC (Canada)

    1996-03-25

    Three typical mechanical heart valves (Starr-Edwards, Bjork-Shiley c-c and St. Jude Medical) have been tested in the mitral position under pulsatile flow conditions. The test program included measurements of velocity and turbulent stresses at six downstream locations. The study was carried out using a sophisticated cardiac simulator in conjunction with a highly sensitive two-component laser Doppler anemometer system. The continuous monitoring of parametric time histories revealed useful details about the complex flow and also helped established location and time of the peak parameter values. Based on the experimental data, the following general conclusions can be drawn: (1) all 3 valve designs generated elevated turbulent stresses during acceleration and peak flow phases, presenting a possibility of thromboembolism, and perhaps, hemolysis; (2) valve configuration and valve orientation significantly affect the flow characteristics; (3) the Starr-Edwards valve with relatively a small opening area shows lower turbulent stresses; and (4) the bileaflet design of the St. Jude Medical valve is also associated with lower turbulent stresses, as compared to the Bjork-Shiley c-c valve. 7 refs., 14 figs.

  10. Effect of Induced Vibration on the Blood Flow Properties in a Mechanical Aortic Valve

    Directory of Open Access Journals (Sweden)

    Kadhim Saleem Khalefa

    2014-07-01

    Full Text Available The effect of induced vibration on velocity distribution for the blood flow in the bileaflet mechanical heart valves conveying blood was investigated in this study. The bileaflet valve was simulated as an orifice. The induced vibration is due to the pulsed blood flow in the artery. Results presented in this study were performed using CFD FLUENT software. This analysis is based on the non-linear numerical solution by using a finite-element method, for the system of governing partial differential equations (continuity, momentum of Navier - Stokes equation of blood flow through the orifice. It has been found that as the flow through the orifice increased, the vibration at the orifice inlet increased. For steady state conditions, at Reynolds number 50 the recorded frequency was 20Hz. When the Reynolds number increased to 100 due to the increase in the blood flow the recorded frequency increased to 30Hz. The increase in frequency may result in damaging the blood red cells and platelets which subsequently results in increasing the blood clogging downstream of the orifice.

  11. Exercise Testing Induces Fatal Thromboembolism: from Mechanical Mitral Valve

    OpenAIRE

    Yavuzgil, Oguz; Ozerkan, Filiz; Gurgun, Cemil; Zoghi, Mehdi; Can, Levent.; AKIN, Mustafa

    2002-01-01

    Thromboembolism is still one of the most important complications of prosthetic heart valves. Embolism to a major coronary branch is rare, but acute proximal occlusions can be fatal, even when the coronary arteries are otherwise normal and intervention is rapid. We report a fatal complication of an exercise test in a patient who had a St. Jude bileaflet mitral valve.

  12. A biocompatible flow chamber to study the hemodynamic performance of prosthetic heart valves.

    Science.gov (United States)

    Yin, Wei; Ngwe, Ek Ching; Rubenstein, David A

    2012-01-01

    The goal of this study was to design, fabricate, and characterize a biocompatible flow chamber to study the performance of artificial heart valves. The system consists of a testing fluid chamber and a water chamber (separated by a latex diaphragm), following the design of a left ventricular assist device. Two St. Jude bileaflet mechanical heart valves were placed oppositely in the testing fluid chamber to control flow direction. The flow rate of the testing fluid chamber was set at 5.6 L/min, with a stroke volume of 80 ml. The performance of the system was examined through three-dimensional numerical simulation and in vitro experiments with whole blood and washed platelets. Hemolysis was measured with whole blood using a spectrophotometer. Platelet activation was measured by platelet surface P-selectin expression using flow cytometry. The three-dimensional computational fluid dynamics model demonstrated that the flow field in the chamber was laminar and physiological. Results from in vitro experiments indicated that the flow conditions in the chamber did not induce hemolysis or platelet activation with the presence of St. Jude heart valves. Overall, the flow chamber can provide a feasible environment to study the hemodynamic performance of artificial heart valves. PMID:22951894

  13. Mechanism of relation among heart meridian, referred cardiac pain and heart

    Institute of Scientific and Technical Information of China (English)

    RONG; Peijing(荣培晶); ZHU; Bing(朱兵)

    2002-01-01

    It has been demonstrated that an important clinical phenomenon often associated with visceral diseases is the referred pain to somatic structures, especially to the body areaof homo-segmental innervation. It is interesting that the somatic foci of cardiac referred pain wereoften and mainly distributed along the heart meridian (HM), whereas the acupoints of HM havebeen applied to treat cardiac disease since ancient times. The purpose of this study was to inves-tigate the neural relationship between the cardiac referred pain and the heart meridian.Fluorescent triple-labeling was injected into the pericardium, some acupoints of HM and lung me-ridian (LM, for control). The responses of the left cardiac sympathetic nerve and of the EMG in left HM and LM were electrophysiologically studied, when the electrical stimuli were applied to the acupoints of left HM and to the left cardiac sympathetic nerve. More double-labeled neurons in HM-heart, not in LM-heart, were observed in the ipsilateral dorsal root ganglia of the spinal segments C8-T3. Electric stimulation of the acupoints of left HM was able to elicit more responses of left cardiac sympathetic nerve than that of the LM-acupoints. Electric stimulation of the left cardiac sympathetic nerve resulted in stronger activities of EMG-response in the acupoints of left HM than in LM-acupoints. We conclude that double-labeling study has provided direct evidence for the existence of dichotomizing afferent fibers that supply both the pericardium and HM. Electrophysiological results show that HM is more closely related functionally to heart. These findings provide a possible morphological and physiological explanation for the referred cardiac pain and HM-heart interrelation.

  14. Fractal mechanisms in the electrophysiology of the heart

    Science.gov (United States)

    Goldberger, A. L.

    1992-01-01

    The mathematical concept of fractals provides insights into complex anatomic branching structures that lack a characteristic (single) length scale, and certain complex physiologic processes, such as heart rate regulation, that lack a single time scale. Heart rate control is perturbed by alterations in neuro-autonomic function in a number of important clinical syndromes, including sudden cardiac death, congestive failure, cocaine intoxication, fetal distress, space sickness and physiologic aging. These conditions are associated with a loss of the normal fractal complexity of interbeat interval dynamics. Such changes, which may not be detectable using conventional statistics, can be quantified using new methods derived from "chaos theory.".

  15. Thromboembolism and mechanical heart valves : A randomized study revisited

    NARCIS (Netherlands)

    Kuntze, CEE; Blackstone, EH; Ebels, T

    1998-01-01

    Background. This study was designed to revise and substantiate previous inferences, based on short-term follow-up, about differences in the incidence of anticoagulant-related events after heart valve replacement among patients who had been randomly assigned to receive either a Bjork-Shiley, Edwards-

  16. Unraveling the mechanisms for heart failure patients' beliefs about compliance

    NARCIS (Netherlands)

    van der Wal, Martje H. L.; Jaarsma, Tiny; Moser, Debra K.; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2007-01-01

    BACKGROUND: Compliance with medication, diet, and monitoring symptoms is a problem in heart failure (HF) patients. Noncompliance can lead to worsening symptoms and is associated with personal beliefs about compliance. To intervene effectively, knowledge of factors related to patients' beliefs about

  17. Protective Mechanisms of Mitochondria and Heart Function in Diabetes

    OpenAIRE

    Aon, Miguel A.; Tocchetti, Carlo G.; Bhatt, Niraj; Paolocci, Nazareno; Cortassa, Sonia

    2015-01-01

    Significance: The heart depends on continuous mitochondrial ATP supply and maintained redox balance to properly develop force, particularly under increased workload. During diabetes, however, myocardial energetic-redox balance is perturbed, contributing to the systolic and diastolic dysfunction known as diabetic cardiomyopathy (DC). Critical Issues: How these energetic and redox alterations intertwine to influence the DC progression is still poorly understood. Excessive bioavailability of bot...

  18. Influence of metabolic dysfunction on cardiac mechanics in decompensated hypertrophy and heart failure.

    Science.gov (United States)

    Tewari, Shivendra G; Bugenhagen, Scott M; Vinnakota, Kalyan C; Rice, J Jeremy; Janssen, Paul M L; Beard, Daniel A

    2016-05-01

    Alterations in energetic state of the myocardium are associated with decompensated heart failure in humans and in animal models. However, the functional consequences of the observed changes in energetic state on mechanical function are not known. The primary aim of the study was to quantify mechanical/energetic coupling in the heart and to determine if energetic dysfunction can contribute to mechanical failure. A secondary aim was to apply a quantitative systems pharmacology analysis to investigate the effects of drugs that target cross-bridge cycling kinetics in heart failure-associated energetic dysfunction. Herein, a model of metabolite- and calcium-dependent myocardial mechanics was developed from calcium concentration and tension time courses in rat cardiac muscle obtained at different lengths and stimulation frequencies. The muscle dynamics model accounting for the effect of metabolites was integrated into a model of the cardiac ventricles to simulate pressure-volume dynamics in the heart. This cardiac model was integrated into a simple model of the circulation to investigate the effects of metabolic state on whole-body function. Simulations predict that reductions in metabolite pools observed in canine models of heart failure can cause systolic dysfunction, blood volume expansion, venous congestion, and ventricular dilation. Simulations also predict that myosin-activating drugs may partially counteract the effects of energetic state on cross-bridge mechanics in heart failure while increasing myocardial oxygen consumption. Our model analysis demonstrates how metabolic changes observed in heart failure are alone sufficient to cause systolic dysfunction and whole-body heart failure symptoms. PMID:27085901

  19. Valve-related complications after mechanical heart valve implantation.

    Science.gov (United States)

    Misawa, Yoshio

    2015-10-01

    The number of heart valve surgeries is increasing, and 19,164 patients underwent heart valve surgery in Japan in 2011. The early mortality rate has remained stable for more than 10 years. Many patients now survive for many years, with a reported 10-year survival rate of at least 60 %. However, unfavorable complications can occur after valve surgery. Valve-related complications include thromboembolisms, bleeding complications and prosthetic valve endocarditis, followed by structural and nonstructural prosthetic valve dysfunctions. Our review of studies published after 2000 revealed that the rate of all valve-related complications was 0.7-3.5 % per patient-year. Thromboembolisms occur at a rate of approximately 1 % per patient-year, and bleeding complications occur at almost 0.5 % per patient-year. Thromboembolic and hemorrhagic events related to anticoagulant therapy should be considered during life-long follow-up. The occurrence rate of endocarditis reaches 0.5 % per patient-year, with a poor postoperative survival. Structural dysfunctions have been largely overcome, and the nonstructural dysfunction rate is 0.4-1.2 % per patient-year. The nonstructural dysfunctions induced by paravalvular leaks and pannus ingrowth are also issues that need to be resolved.

  20. Mechanisms of Disease: detrimental adrenergic signaling in acute decompensated heart failure

    OpenAIRE

    Feldman, David S.; Elton, Terry S; Sun, Benjamin; Martin, Mickey M.; Ziolo, Mark T

    2008-01-01

    Acute decompensated heart failure (ADHF) is responsible for more than 1 million hospital admissions each year in the US. Clinicians and scientists have developed therapeutic strategies that reduce mortality in patients with chronic heart failure (HF). Despite the widely appreciated magnitude of the ADHF problem, there is still a critical gap in our understanding of the cellular mechanisms involved and effective treatment strategies for hospitalized patients. Irrespective of the etiology, pati...

  1. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors.

    Science.gov (United States)

    Dubé, Bruno-Pierre; Agostoni, Piergiuseppe; Laveneziana, Pierantonio

    2016-09-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology.Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators or inotropes that improve central haemodynamics, patients with heart failure still complain of exertional dyspnoea. Clearly, dyspnoea is not determined by cardiac factors alone, but likely depends on complex, integrated cardio-pulmonary interactions.A growing body of evidence suggests that excessively increased ventilatory demand and abnormal "restrictive" constraints on tidal volume expansion with development of critical mechanical limitation of ventilation, contribute to exertional dyspnoea in heart failure. This article will offer new insights into the pathophysiological mechanisms of exertional dyspnoea in patients with chronic heart failure by exploring the potential role of the various constituents of the physiological response to exercise and particularly the role of abnormal ventilatory and respiratory mechanics responses to exercise in the perception of dyspnoea in patients with heart failure. PMID:27581831

  2. ENDURANCE TRAINING AND GLUTATHIONE-DEPENDENT ANTIOXIDANT DEFENSE MECHANISM IN HEART OF THE DIABETIC RATS

    Directory of Open Access Journals (Sweden)

    Mustafa Atalay

    2003-06-01

    Full Text Available Regular physical exercise beneficially influences cardiac antioxidant defenses in normal rats. The aim of this study was to test whether endurance training can strengthen glutathione-dependent antioxidant defense mechanism and decrease lipid peroxidation in heart of the streptozotocin-induced diabetic rats. Redox status of glutathione in blood of diabetic rats in response to training and acute exercise was also examined. Eight weeks of treadmill training increased the endurance in streptozotocin-induced diabetic rats. It did not affect glutathione level in heart tissue at rest and also after exercise. On the other hand, endurance training decreased glutathione peroxidase activity in heart, while glutathione reductase and glutathione S-transferase activities were not affected either by acute exhaustive exercise or endurance training. Reduced and oxidized glutathione levels in blood were not affected by either training or acute exercise. Conjugated dienes levels in heart tissue were increased by acute exhaustive exercise and also 8 weeks treadmill training. Longer duration of exhaustion in trained group may have contributed to the increased conjugated dienes levels in heart after acute exercise. Our results suggest that endurance type exercise may make heart more susceptible to oxidative stress. Therefore it may be wise to combine aerobic exercise with insulin treatment to prevent its adverse effects on antioxidant defense in heart in patients with diabetes mellitus

  3. Self-management of oral anticoagulant therapy for mechanical heart valve patients

    DEFF Research Database (Denmark)

    Christensen, Thomas D; Attermann, Jørn; Pilegaard, Hans K;

    2001-01-01

    .4%–2.9%) for the control group. Conclusion: Self-management of OAT is a feasible and safe concept for selected patients with mechanical heart valve prostheses also on a long-term basis. It provides at least as good and most likely better quality of anticoagulant therapy than conventional management assessed by time within......Objective: Self-management of oral anticoagulant therapy (OAT) has shown good results on a short-term basis. We hypothesize that self-management of OAT provides a better quality of treatment than conventional management also on a long-term basis. The aim of this study was to assess the quality...... of self-management of OAT in patients with mechanical heart valve prostheses on a 4-year perspective in a prospective, non-randomized study. Design: Twenty-four patients with mechanical heart valves and on self-managed OAT were followed for up to 4 years. A matched, retrospectively selected group...

  4. [Long-term mechanical circulatory support in 2014: A real alternative to heart transplantation?].

    Science.gov (United States)

    Flécher, Erwan

    2014-01-01

    Cardiac transplantation remains the gold standard for end stage heart failure however results of long-term mechanical circulatory support have dramatically improved over the last 10years. One should now clearly consider a left ventricular assist device as bridge to transplant or destination therapy in refractory isolated left heart failure. Mechanical biventricular support remains more challenging with lower survival and may be proposed as bridge to transplant. Correct patient's selection and appropriate follow-up are mandatory in such critical patients. PMID:24933679

  5. Stress activated contractile wavefronts in the mechanically-excitable embryonic heart

    Science.gov (United States)

    Chiou, Kevin; Majkut, Stephanie; Discher, Dennis; Lubensky, Tom; Liu, Andrea

    2014-03-01

    The heart is a prime example of a robust, active system with behavior-the heart beat-that is extraordinarily well timed and coordinated. For more than half a century, electrical activity induced by ion release and diffusion has been argued to be the mechanism driving cardiac action. But recent work indicates that this phenomenon is also regulated by mechanical activity. In the embryonic avian heart tube, the speed of the contractile wavefront traversing the heart tube with each beat is measured to be a monotonic, linear function of tissue stiffness. Traditional electrical conduction models of excitation-contraction cannot explain this dependence; such a result indicates that the myocardium is mechanically excitable. Here, we extend this work by using experimental observations of stiffness-dependent behavior in isolated cardiomyocytes as an input to study contractile wavefronts in the tissue as a whole. We model the heart tube as an active, overdamped elastic network where the primary stress mediator is the extracellular matrix. Using this simple model, we explain experimental observations of the systolic wave and predict qualitatively new behavior.

  6. A New Animal Model for Investigation of Mechanical Unloading in Hypertrophic and Failing Hearts: Combination of Transverse Aortic Constriction and Heterotopic Heart Transplantation.

    Directory of Open Access Journals (Sweden)

    Andreas Schaefer

    Full Text Available Previous small animal models for simulation of mechanical unloading are solely performed in healthy or infarcted hearts, not representing the pathophysiology of hypertrophic and dilated hearts emerging in heart failure patients. In this article, we present a new and economic small animal model to investigate mechanical unloading in hypertrophic and failing hearts: the combination of transverse aortic constriction (TAC and heterotopic heart transplantation (hHTx in rats.To induce cardiac hypertrophy and failure in rat hearts, three-week old rats underwent TAC procedure. Three and six weeks after TAC, hHTx with hypertrophic and failing hearts in Lewis rats was performed to induce mechanical unloading. After 14 days of mechanical unloading animals were euthanatized and grafts were explanted for further investigations.50 TAC procedures were performed with a survival of 92% (46/50. When compared to healthy rats left ventricular surface decreased to 5.8±1.0 mm² (vs. 9.6± 2.4 mm² (p = 0.001 after three weeks with a fractional shortening (FS of 23.7± 4.3% vs. 28.2± 1.5% (p = 0.01. Six weeks later, systolic function decreased to 17.1± 3.2% vs. 28.2± 1.5% (p = 0.0001 and left ventricular inner surface increased to 19.9±1.1 mm² (p = 0.0001. Intraoperative graft survival during hHTx was 80% with 46 performed procedures (37/46. All transplanted organs survived two weeks of mechanical unloading.Combination of TAC and hHTx in rats offers an economic and reproducible small animal model enabling serial examination of mechanical unloading in a truly hypertrophic and failing heart, representing the typical pressure overloaded and dilated LV, occurring in patients with moderate to severe heart failure.

  7. Advanced research on the microRNA mechanism in heart failure.

    Science.gov (United States)

    Deng, Jianying; Zhong, Qianjin

    2016-10-01

    Heart failure is the end stage of most cardiac diseases and also an important cardiovascular disease. Ventricular remodeling, a complicated pathophysiological process involving multiple molecular pathways, is a crucial mechanism for the occurrence and development of heart failure. A microRNA (miRNA) is a highly conservative noncoding molecule containing 18-25 nucleotides. miRNA is different from other RNAs. It mainly serves as an endogenous gene-regulating factor, and is a member of the complex regulatory network. It induces gene repression of target transcripts by affecting mRNA at the post-transcriptional level Vasudevan et al. (2007) . This study aimed at determining the mechanism of miRNA action in heart failure. PMID:27372044

  8. A surgical robot with a heart-surface-motion synchronization mechanism for myoblast cell sheet transplantation.

    Science.gov (United States)

    Xu, Kangyi; Nakamura, Ryoichi

    2013-01-01

    Myoblast cell sheets are employed in the clinical treatment of heart disorders. We propose a surgical robot system with two endoscopic cameras, characterized by a double remote center of motion (RCM) mechanism, to realize heart-surface-motion synchronization movement for myoblast cell sheet transplantation on a beating heart surface. A robot system with the double RCM mechanism was developed for which the linear and rotation motions are totally isolated, and an experiment was conducted to evaluate the tracking accuracy of the robot system when tracking a randomly moving target. The tracking data were updated with a Polaris system at 30 Hz. The experiment results showed linear and rotation tracking errors of 4.93 ± 5.92 mm and 2.54 ± 5.44°, respectively.

  9. Relaxin for the Treatment of Acute Decompensated Heart Failure: Pharmacology, Mechanisms of Action, and Clinical Evidence.

    Science.gov (United States)

    Ng, Tien M H; Goland, Sorel; Elkayam, Uri

    2016-01-01

    Acute heart failure remains a major cause of morbidity, and its treatment requires an increasing investment of the health care system. Whereas success in treating chronic heart failure has been achieved over the last decades, several pharmacological approaches for acute heart failure have been introduced but have failed to demonstrate any clinical benefit. Serelaxin is a recombinant human relaxin-2 vasoactive peptide that causes systemic and renal vasodilation. Data suggest that the clinical benefits may be attributable to a potential combination of multiple actions of serelaxin, including improving systemic, cardiac, and renal hemodynamics, and protecting cells and organs from damage via neurohormonal, anti-inflammatory, antiremodeling, antifibrotic, anti-ischemic, and proangiogenic effects. Recently, a number of clinical trials have demonstrated that serelaxin infusion over 48 hours improved dyspnea with more rapid relief of congestion during the first days after admission for heart failure. In addition, administration of serelaxin diminished cardiac, renal, and hepatic damage, which were associated with improved long-term mortality. Available data support substantial clinical benefits and significant promise for serelaxin as a treatment option for patients with acute heart failure. This review focuses on the pharmacology and mechanisms of action of serelaxin and provides a detailed discussion of the clinical evidence for this novel therapy in acute heart failure. PMID:26331289

  10. Education and Coronary Heart Disease Risk: Potential Mechanisms Such as Literacy, Perceived Constraints, and Depressive Symptoms

    Science.gov (United States)

    Loucks, Eric B.; Gilman, Stephen E.; Howe, Chanelle J.; Kawachi, Ichiro; Kubzansky, Laura D.; Rudd, Rima E.; Martin, Laurie T.; Nandi, Arijit; Wilhelm, Aude; Buka, Stephen L.

    2015-01-01

    Objective: Education is inversely associated with coronary heart disease (CHD) risk; however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in…

  11. [Mechanism of "treating heart and brain with same methods" based on data science].

    Science.gov (United States)

    Chen, Di; Tang, Shi-huan; Lu, Peng; Yang, Hong-jun

    2015-11-01

    The traditional Chinese medicine (TCM) theory of "treating heart and brain diseases with same methods (Nao Xin Tong Zhi: NXTZ)" has great significance to the treatment of cardiovascular and cerebrovascular diseases. It has been proven effective by a great deal of clinical researches. However, the underlying mechanism for this theory is still unclear. To provide insights into the potential mechanism of "NXTZ", this study attempts to deeply investigate the mechanism from two representative cardiovascular and cerebrovascular diseases, coronary heart disease (CHD) and cerebral apoplexy. First, various data resources were integrated to obtain different types of biomedical entities including drugs, targets, pathways and diseases. Then, three different approaches including text mining, biological network and enrichment analysis were utilized to recognize the potential common features between CHD and cerebral apoplexy, and the corresponding functions of drugs which could treat both diseases, thus unveiling the mechanism of NXTZ. PMID:27071272

  12. Chronic heart failure modifies respiratory mechanics in rats: a randomized controlled trial

    OpenAIRE

    Deise M. Pacheco; Viviane D. Silveira; Alex Thomaz; Ramiro B Nunes; Viviane R. Elsner; Pedro Dal Lago

    2016-01-01

    ABSTRACT Objective To analyze respiratory mechanics and hemodynamic alterations in an experimental model of chronic heart failure (CHF) following myocardial infarction. Method Twenty-seven male adult Wistar rats were randomized to CHF group (n=12) or Sham group (n=15). Ten weeks after coronary ligation or sham surgery, the animals were anesthetized and submitted to respiratory mechanics and hemodynamic measurements. Pulmonary edema as well as cardiac remodeling were measured. Results The C...

  13. NON-LIPID MECHANISMS OF STATINS ACTION FOR HEART TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    А. О. Shevchenko

    2013-01-01

    Full Text Available Statins are widely used in the treatment of heart transplant recipients. It is assumed that the effectiveness of statins after heart transplantation is due not only to hypolipidemic effects, but also to non-lipid effects, including anti-inflammato- ry. In the review are presented the recently published results of the pro-and retrospective studies on the role of statins in the treatment of post-heart transplant recipients. Also there were analyzed the immunomodulatory and anti-in- flammatory mechanisms based on reduced levels of C-reactive protein, decreased concentration of cytokines (TNF-α, IL-6, IL-2R, suppression of tissue factor expression by monocytes etc. Another important factor is the role of statins in reducing the risk of cancer for transplant recipients. The use of statins in the treatment with immunosuppressive agents is an important factor in optimizing the long-term outcomes, reduction in the incidence of acute rejection and coronary artery disease of transplanted heart, increasing the duration and quality of life for heart transplant recipients. 

  14. Fast Simulation of Mechanical Heterogeneity in the Electrically Asynchronous Heart Using the MultiPatch Module.

    Directory of Open Access Journals (Sweden)

    John Walmsley

    2015-07-01

    Full Text Available Cardiac electrical asynchrony occurs as a result of cardiac pacing or conduction disorders such as left bundle-branch block (LBBB. Electrically asynchronous activation causes myocardial contraction heterogeneity that can be detrimental for cardiac function. Computational models provide a tool for understanding pathological consequences of dyssynchronous contraction. Simulations of mechanical dyssynchrony within the heart are typically performed using the finite element method, whose computational intensity may present an obstacle to clinical deployment of patient-specific models. We present an alternative based on the CircAdapt lumped-parameter model of the heart and circulatory system, called the MultiPatch module. Cardiac walls are subdivided into an arbitrary number of patches of homogeneous tissue. Tissue properties and activation time can differ between patches. All patches within a wall share a common wall tension and curvature. Consequently, spatial location within the wall is not required to calculate deformation in a patch. We test the hypothesis that activation time is more important than tissue location for determining mechanical deformation in asynchronous hearts. We perform simulations representing an experimental study of myocardial deformation induced by ventricular pacing, and a patient with LBBB and heart failure using endocardial recordings of electrical activation, wall volumes, and end-diastolic volumes. Direct comparison between simulated and experimental strain patterns shows both qualitative and quantitative agreement between model fibre strain and experimental circumferential strain in terms of shortening and rebound stretch during ejection. Local myofibre strain in the patient simulation shows qualitative agreement with circumferential strain patterns observed in the patient using tagged MRI. We conclude that the MultiPatch module produces realistic regional deformation patterns in the asynchronous heart and that

  15. Endurance Training and Glutathione-Dependent Antioxidant Defense Mechanism in Heart of the Diabetic Rats

    OpenAIRE

    Mustafa Atalay; Osmo Hanninen; Mustafa Gul

    2003-01-01

    Regular physical exercise beneficially influences cardiac antioxidant defenses in normal rats. The aim of this study was to test whether endurance training can strengthen glutathione-dependent antioxidant defense mechanism and decrease lipid peroxidation in heart of the streptozotocin-induced diabetic rats. Redox status of glutathione in blood of diabetic rats in response to training and acute exercise was also examined. Eight weeks of treadmill training increased the endurance in streptozoto...

  16. Low-dose copper infusion into the coronary circulation induces acute heart failure in diabetic rats: New mechanism of heart disease.

    Science.gov (United States)

    Cheung, Carlos Chun Ho; Soon, Choong Yee; Chuang, Chia-Lin; Phillips, Anthony R J; Zhang, Shaoping; Cooper, Garth J S

    2015-09-01

    Diabetes impairs copper (Cu) regulation, causing elevated serum Cu and urinary Cu excretion in patients with established cardiovascular disease; it also causes cardiomyopathy and chronic cardiac impairment linked to defective Cu homeostasis in rats. However, the mechanisms that link impaired Cu regulation to cardiac dysfunction in diabetes are incompletely understood. Chronic treatment with triethylenetetramine (TETA), a Cu²⁺-selective chelator, improves cardiac function in diabetic patients, and in rats with heart disease; the latter displayed ∼3-fold elevations in free Cu²⁺ in the coronary effluent when TETA was infused into their coronary arteries. To further study the nature of defective cardiac Cu regulation in diabetes, we employed an isolated-perfused, working-heart model in which we infused micromolar doses of Cu²⁺ into the coronary arteries and measured acute effects on cardiac function in diabetic and non-diabetic-control rats. Infusion of CuCl₂ solutions caused acute dose-dependent cardiac dysfunction in normal hearts. Several measures of baseline cardiac function were impaired in diabetic hearts, and these defects were exacerbated by low-micromolar Cu²⁺ infusion. The response to infused Cu²⁺ was augmented in diabetic hearts, which became defective at lower infusion levels and underwent complete pump failure (cardiac output = 0 ml/min) more often (P hearts. To our knowledge, this is the first report describing the acute effects on cardiac function of pathophysiological elevations in coronary Cu²⁺. The effects of Cu²⁺ infusion occur within minutes in both control and diabetic hearts, which suggests that they are not due to remodelling. Heightened sensitivity to the acute effects of small elevations in Cu²⁺ could contribute substantively to impaired cardiac function in patients with diabetes and is thus identified as a new mechanism of heart disease.

  17. THE RESULTS OF MECHANICAL HEART SUPPORT SYSTEMS «INCOR» IMPLANTATION

    Directory of Open Access Journals (Sweden)

    A. M. Cherniavskiy

    2013-01-01

    Full Text Available The aim of investigation isestimation of mechanical heart support system «INCOR» implantation efficacy. Materials and methods. The Institute of Circulation Pathology has clinical experience of mechanical circulatory support systems «INCOR» (Berlin Heart AG implantation in 12 patients (10 men and 2 women with severe heart failure during the period from November 2006 to October 2012. The main indication for the use of mechanical support of the left ventricle was a left ventricular failure with marked dilatation of the left heart: end-diastolic volume (EDV, LV – 283 ± 58 ml, end-systolic volume (ESV – 233 ± 57 ml, ejection fraction (EF – 16 ± 7%, with preserved function of the right ventricle (RV (RV ejection fraction 35 ± 12%. Results. All patients showed a significant improvement in central hemodynamics in early postoperative period, reducing the volume of the heart chambers: LV EDV from 283 ± 58 to 183 ± 94 ml; LV ESV with 234 ± 57 to 157 ± 65 ml, increased right ventricular ejection fraction (RV EF (from 35 ± 12 to 43 ± 17%. Improve the function of the right ventricle oc- curred mainly due to the expense of left ventricular unloading and pulmonary circulation. In addition, there was a significant improvement in clinical status of patients – regression of symptoms of heart failure, a recovery of the liver and kidney function. Despite the ongoing anticoagulation and antiplatelet therapy under constant parameters of coagulation, there was some complications. Uterine bleeding occurred in 1 patient (16.6%, which required the abolition of anticoagulants and antiplatelet, uterine artery embolization, and as a result has led to thrombosis and stop system «INCOR». Four patients (33.3% had severe thromboembolic complications – acute cerebrovascular accident (CVA. In 1 patient (8% there was a hemorrhagic stroke due to rupture of intracerebral aneurysms with a breakthrough into the lateral ventricle of the brain. In 3 patients (25

  18. Itraconazole decreases left ventricular contractility in isolated rabbit heart: Mechanism of action

    Energy Technology Data Exchange (ETDEWEB)

    Qu, Yusheng, E-mail: yqu@amgen.com [Toxicology Science, Amgen, Inc, One Amgen Center Drive, Thousand Oaks, CA 91320 (United States); Fang, Mei; Gao, BaoXi; Amouzadeh, Hamid R. [Toxicology Science, Amgen, Inc, One Amgen Center Drive, Thousand Oaks, CA 91320 (United States); Li, Nianyu; Narayanan, Padma [Discovery Toxicology, Amgen, Inc, One Amgen Center Drive, Thousand Oaks, CA 91320 (United States); Acton, Paul; Lawrence, Jeff; Vargas, Hugo M. [Toxicology Science, Amgen, Inc, One Amgen Center Drive, Thousand Oaks, CA 91320 (United States)

    2013-04-15

    Itraconazole (ITZ) is an approved antifungal agent that carries a “black box warning” in its label regarding a risk of negative cardiac inotropy based on clinical findings. Since the mechanism of the negative inotropic effect is unknown, we performed a variety of preclinical and mechanistic studies to explore the pharmacological profile of ITZ and understand the negative inotropic mechanism. ITZ was evaluated in: (1) an isolated rabbit heart (IRH) preparation using Langendorff retrograde perfusion; (2) ion channel studies; (3) a rat heart mitochondrial function profiling screen; (4) a mitochondrial membrane potential (MMP) assay; (5) in vitro pharmacology profiling assays (148 receptors, ion channels, transporters, and enzymes); and (6) a kinase selectivity panel (451 kinases). In the IRH, ITZ decreased cardiac contractility (> 30%) at 0.3 μM, with increasing effect at higher concentrations, which indicated a direct negative inotropic effect upon the heart. It also decreased heart rate and coronary flow (≥ 1 μM) and prolonged PR/QRS intervals (3 μM). In mechanistic studies, ITZ inhibited the cardiac NaV channel (IC{sub 50}: 4.2 μM) and was devoid of any functional inhibitory effect at the remaining pharmacological targets. Lastly, ITZ did not affect MMP, nor interfere with mitochondrial enzymes or processes involved with fuel substrate utilization or energy formation. Overall, the cardiovascular and mechanistic data suggest that ITZ-induced negative inotropy is a direct effect on the heart, in addition, the potential involvement of mitochondria function and L-type Ca{sup 2+} channels are eliminated. The exact mechanism underlying the negative inotropy is uncertain, and requires further study. - Highlights: ► Effect of itraconazole (ITZ) was assessed in the isolated rabbit heart (IRH) assay. ► ITZ decreased ventricular contractility in IRH, indicating a direct effect. ► IC{sub 50} of ITZ on L-type I{sub Ca} was greater than 30 μM, on I{sub Na} was 4

  19. Predominance of Intrinsic Mechanism of Resting Heart Rate Control and Preserved Baroreflex Sensitivity in Professional Cyclists after Competitive Training.

    Science.gov (United States)

    Azevedo, Luciene Ferreira; Perlingeiro, Patricia; Hachul, Denise Tessariol; Gomes-Santos, Igor Lucas; Tsutsui, Jeane Mike; Negrao, Carlos Eduardo; De Matos, Luciana D N J

    2016-01-01

    Different season trainings may influence autonomic and non-autonomic cardiac control of heart rate and provokes specific adaptations on heart's structure in athletes. We investigated the influence of transition training (TT) and competitive training (CT) on resting heart rate, its mechanisms of control, spontaneous baroreflex sensitivity (BRS) and relationships between heart rate mechanisms and cardiac structure in professional cyclists (N = 10). Heart rate (ECG) and arterial blood pressure (Pulse Tonometry) were recorded continuously. Autonomic blockade was performed (atropine-0.04 mg.kg-1; esmolol-500 μg.kg-1 = 0.5 mg). Vagal effect, intrinsic heart rate, parasympathetic (n) and sympathetic (m) modulations, autonomic influence, autonomic balance and BRS were calculated. Plasma norepinephrine (high-pressure liquid chromatography) and cardiac structure (echocardiography) were evaluated. Resting heart rate was similar in TT and CT. However, vagal effect, intrinsic heart rate, autonomic influence and parasympathetic modulation (higher n value) decreased in CT (P≤0.05). Sympathetic modulation was similar in both trainings. The autonomic balance increased in CT but still showed parasympathetic predominance. Cardiac diameter, septum and posterior wall thickness and left ventricular mass also increased in CT (P<0.05) as well as diastolic function. We observed an inverse correlation between left ventricular diastolic diameter, septum and posterior wall thickness and left ventricular mass with intrinsic heart rate. Blood pressure and BRS were similar in both trainings. Intrinsic heart rate mechanism is predominant over vagal effect during CT, despite similar resting heart rate. Preserved blood pressure levels and BRS during CT are probably due to similar sympathetic modulation in both trainings. PMID:26812615

  20. Predominance of Intrinsic Mechanism of Resting Heart Rate Control and Preserved Baroreflex Sensitivity in Professional Cyclists after Competitive Training.

    Directory of Open Access Journals (Sweden)

    Luciene Ferreira Azevedo

    Full Text Available Different season trainings may influence autonomic and non-autonomic cardiac control of heart rate and provokes specific adaptations on heart's structure in athletes. We investigated the influence of transition training (TT and competitive training (CT on resting heart rate, its mechanisms of control, spontaneous baroreflex sensitivity (BRS and relationships between heart rate mechanisms and cardiac structure in professional cyclists (N = 10. Heart rate (ECG and arterial blood pressure (Pulse Tonometry were recorded continuously. Autonomic blockade was performed (atropine-0.04 mg.kg-1; esmolol-500 μg.kg-1 = 0.5 mg. Vagal effect, intrinsic heart rate, parasympathetic (n and sympathetic (m modulations, autonomic influence, autonomic balance and BRS were calculated. Plasma norepinephrine (high-pressure liquid chromatography and cardiac structure (echocardiography were evaluated. Resting heart rate was similar in TT and CT. However, vagal effect, intrinsic heart rate, autonomic influence and parasympathetic modulation (higher n value decreased in CT (P≤0.05. Sympathetic modulation was similar in both trainings. The autonomic balance increased in CT but still showed parasympathetic predominance. Cardiac diameter, septum and posterior wall thickness and left ventricular mass also increased in CT (P<0.05 as well as diastolic function. We observed an inverse correlation between left ventricular diastolic diameter, septum and posterior wall thickness and left ventricular mass with intrinsic heart rate. Blood pressure and BRS were similar in both trainings. Intrinsic heart rate mechanism is predominant over vagal effect during CT, despite similar resting heart rate. Preserved blood pressure levels and BRS during CT are probably due to similar sympathetic modulation in both trainings.

  1. Multi-scale mechanical characterization of scaffolds for heart valve tissue engineering.

    Science.gov (United States)

    Argento, G; Simonet, M; Oomens, C W J; Baaijens, F P T

    2012-11-15

    Electrospinning is a promising technology to produce scaffolds for cardiovascular tissue engineering. Each electrospun scaffold is characterized by a complex micro-scale structure that is responsible for its macroscopic mechanical behavior. In this study, we focus on the development and the validation of a computational micro-scale model that takes into account the structural features of the electrospun material, and is suitable for studying the multi-scale scaffold mechanics. We show that the computational tool developed is able to describe and predict the mechanical behavior of electrospun scaffolds characterized by different microstructures. Moreover, we explore the global mechanical properties of valve-shaped scaffolds with different microstructural features, and compare the deformation of these scaffolds when submitted to diastolic pressures with a tissue engineered and a native valve. It is shown that a pronounced degree of anisotropy is necessary to reproduce the deformation patterns observed in the native heart valve.

  2. Mechanism of cardioprotective effect of erythropoietin-induced preconditioning in rat heart

    Directory of Open Access Journals (Sweden)

    Garg Kavita

    2010-01-01

    Full Text Available Objective : The cardioprotective potential of human recombinant erythropoietin (alpha (Epo against ischemia-reperfusion-induced injury is well known. But, the underlying mechanisms are not well elucidated. The aim of this study was to characterize the mechanism involved in the cardioprotective effect of Epo-induced preconditioning in isolated rat heart. Materials and Methods : The heart was mounted on a Langendorff apparatus. After 10 min of stabilization, four cycles of ischemic preconditioning (IPC were given followed by 30 min of global ischemia and 120 min of reperfusion. Epo preconditioning was induced by four cycles of 5-min perfusion of K-H solution containing Epo (1.0 U/ml followed by 5 min perfusion with K-H solution. Myocardial infarct size was estimated macroscopically using the triphenyltetrazolium chloride staining technique. The extent of myocardial injury was measured by release of lactate dehydrogenase and creatine kinase-MB in the coronary effluent. Results : The present study demonstrates that Epo preconditioning was almost as effective as IPC. Administration of Wortmannin (100 nM, a PI-3K inhibitor, or Chelerythrine (1 μM, a protein kinase-C (PKC inhibitor, or AG490 (5 μM, a JAK-2 inhibitor, significantly attenuated the cardioprotective effects of Epo-induced preconditioning. Conclusion : Our result suggest that the cardioprotective potential of Epo-induced preconditioning in isolated rat heart was due to an interplay of the JAK-2, PI-3K and PKC pathways. Inhibition of any one of the three pathways was sufficient to block the cardioprotective effect of Epo-induced preconditioning in isolated rat heart.

  3. Control of heart rate during thermoregulation in the heliothermic lizard Pogona barbata: importance of cholinergic and adrenergic mechanisms.

    Science.gov (United States)

    Seebacher, F; Franklin, C E

    2001-12-01

    During thermoregulation in the bearded dragon Pogona barbata, heart rate when heating is significantly faster than when cooling at any given body temperature (heart rate hysteresis), resulting in faster rates of heating than cooling. However, the mechanisms that control heart rate during heating and cooling are unknown. The aim of this study was to test the hypothesis that changes in cholinergic and adrenergic tone on the heart are responsible for the heart rate hysteresis during heating and cooling in P. barbata. Heating and cooling trials were conducted before and after the administration of atropine, a muscarinic antagonist, and sotalol, a beta-adrenergic antagonist. Cholinergic and beta-adrenergic blockade did not abolish the heart rate hysteresis, as the heart rate during heating was significantly faster than during cooling in all cases. Adrenergic tone was extremely high (92.3 %) at the commencement of heating, and decreased to 30.7 % at the end of the cooling period. Moreover, in four lizards there was an instantaneous drop in heart rate (up to 15 beats min(-1)) as the heat source was switched off, and this drop in heart rate coincided with either a drop in beta-adrenergic tone or an increase in cholinergic tone. Rates of heating were significantly faster during the cholinergic blockade, and least with a combined cholinergic and beta-adrenergic blockade. The results showed that cholinergic and beta-adrenergic systems are not the only control mechanisms acting on the heart during heating and cooling, but they do have a significant effect on heart rate and on rates of heating and cooling. PMID:11815660

  4. Univariate Risk Factors for Prolonged Mechanical Ventilation in Patients Undergoing Prosthetic Heart Valves Replacement Surgery

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Data from 736 patients undergoing prosthetic heart valve replacement surgery and concomitant surgery (combined surgery) from January 1998 to January 2004 at Union Hospital were retrospectively reviewed. Univariate logistic regression analyses were conducted to identify risk factors for prolonged mechanical ventilation. The results showed that prolonged cardiopulmonary bypass duration, prolonged aortic cross clamp time and low ejection fraction less than 50 percent (50 %)were found to be independent predictors for prolonged mechanical ventilation. Meanwhile age,weight, and preoperative hospital stay (days) were not found to be associated with prolonged mechanical ventilation. It was concluded that, for age and weight, this might be due to the lower number of old age patients (70 years and above) included in our study and genetic body structure of majority Chinese population that favor them to be in normal weight, respectively.

  5. Mechanism of the negative inotropic effect of naringin in mouse heart.

    Directory of Open Access Journals (Sweden)

    Julio Alvarez-Collazo

    2014-10-01

    Full Text Available Context: Naringin (NRG is the major flavonoid (flavanone glycoside in grapefruit juice. Its biological activity has been only partially characterized and little is known about the mechanism of the negative inotropic action of this flavonoid. Aims: To evaluate the effects of NRG on the surface electrogram (ECG and the force of contraction (FC of mice hearts as well as on the sodium (INa, calcium (ICaL and Na+ – Ca2+ exchange (INaCaX currents of enzymatically isolated mouse ventricular cardiomyocytes. Methods: ECG and FC were recorded on mouse hearts perfused in a Langendorff column. Ventricular cardiomyocytes were enzimatically dissociated and ionic currents recorded with the patch-clamp technique. Results: NRG increased RR interval and shortened corrected QT only at high concentrations (30-100 µM. However, at a fixed heart rate, it decreased FC with an IC50 of 0.4 µM. NRG reduced INa with an IC50 of 0.07 µM but with a maximal inhibition of 60 %. NRG also depressed ICaL with an IC50 of 0.013 µM and increased its fast inactivation time constant. The effects on ICaL were not voltage-dependent. INaCaX was not affected by NRG. Conclusions: Our results indicate that NRG exerts a negative inotropic effect in mice hearts that could be explained by a decrease in INa and ICaL. These actions should be taken into account when considering this molecule either as a dietetic supplement or as a template to develop therapeutic agents for human diseases.

  6. Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease Treated by Noninvasive Mechanic Ventilation

    OpenAIRE

    Zekeriya Küçükdurmaz; İbrahim Gül; Hasan Kaya; Zekeriya Kaya; Alim Erdem; Zuhal Karakurt; Hekim Karapınar; Yusuf Karavelioğlu; Özlem Yazıcıoğlu Moçin; Cevat Kırma

    2011-01-01

    Aims: This study aimed to investigate heart rate variability (HRV) of patients with severe COPD who are treated by noninvasive mechanic ventilation (NIMV).Patients and Method: Twenty-seven patient (58±8 years, 9 F) with severe COPD treated by nocturnal NIMV at home and 23 sex and age matched volunteers (56±8 years, 11 F) who has not dyspnea as a control group recruited in the study. Subjects underwent spirometry, blood gas analysis, transthoracic echocardiography, 24 hours ambulatory ECG anal...

  7. Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease Treated by Noninvasive Mechanic Ventilation

    OpenAIRE

    Karavelioğlu, Yusuf; Karapınar, Hekim; Karakurt, Zuhal; Erdem, Alim; Kaya, Zekeriya; Gül, İbrahim; Küçükdurmaz, Zekeriya; Moçin, Özlem Yazıcıoğlu; Kırma, Cevat

    2010-01-01

    Aims: This study aimed to investigate heart rate variability (HRV) of patients with severe COPD who are treated by noninvasive mechanic ventilation (NIMV). Patients and Method: Twenty-seven patient (58±8 years, 9 F) with severe COPD treated by nocturnal NIMV at home and 23 sex and age matched volunteYusuf ers (56±8 years, 11 F) who has not dyspnea as a control group recruited in the study. Subjects underwent spirometry, blood gas analysis, transthoracic echocardiography, 24 hours ambulatory...

  8. Analysis of electrolyte abnormalities and the mechanisms leading to arrhythmias in heart failure. A literature review.

    Science.gov (United States)

    Urso, C; Canino, B; Brucculeri, S; Firenze, A; Caimi, G

    2016-01-01

    About 50% of deaths from heart failure (HF) are sudden, presumably referable to arrhythmias. Electrolyte and acid-base abnormalities are a frequent and potentially dangerous complication in HF patients. Their incidence is almost always correlated with the severity of cardiac dysfunction; furthermore leading to arrhythmias, these imbalances are associated with a poor prognosis. The frequency of ventricular ectopic beats and sudden cardiac death correlate with both plasma and whole body levels of potassium, especially in alkalemia. The early recognition of these alterations and the knowledge of the pathophysiological mechanisms are useful for the management of these HF patients.

  9. Hemodynamic function of the standard St. Jude bileaflet disc valve has no clinical impact 10 years after aortic valve replacement

    DEFF Research Database (Denmark)

    Lund, Ole; Dorup, Inge; Emmertsen, Kristian;

    2005-01-01

    OBJECTIVES: Size mismatch and impaired left ventricular function have been shown to determine the hemodynamic function of the standard St. Jude bileaflet disc valve early after aortic valve replacement (AVR). We aimed to analyse St. Jude valve hemodynamic function and its clinical impact in the...... regurgitation were excluded from further analysis: they had significantly lower St. Jude valve gradient and left ventricular ejection fraction (LVEF) and larger mass index (LVMi) than 37 without. RESULTS: In the 37 patients without left sided valve regurgitation peak and mean gradients were inversely related to...... St. Jude valve geometric orifice area (GOA) indexed for either body surface area or left ventricular end-diastolic dimension (LVEDD). The gradients correlated directly with LVEDD but not with LVEF or LVMi. Eleven patients with hypertension had higher peak gradients (31+/-13 versus 22+/-8 mmHg, p<0...

  10. Assessment of left atrial volume and mechanical function in ischemic heart disease: a multi slice computed tomography study

    DEFF Research Database (Denmark)

    Kühl, Jørgen Tobias; Kofoed, Klaus F; Møller, Jacob E;

    2010-01-01

    and mechanical function with Multi Slice Computed Tomography (MSCT) in patients with ischemic heart disease. Furthermore, the LA and left ventricular (LV) function was evaluated in relation to signs of clinical heart failure. METHODS AND RESULTS: MSCT was performed in 40 patients with sinus rhythm and ischemic...... heart disease. We enrolled 20 patients with reduced LV ejection fraction (LVEF=45%) and 20 with preserved LVEF (>45%). LA volumes, reservoir, channel and pump function were measured. Interobserver variation for LA volume measures was 1.5% (SD: 6.6%). In patients with reduced LVEF, LA volumes were larger...

  11. Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study

    Directory of Open Access Journals (Sweden)

    Tamatey Martin

    2011-04-01

    Full Text Available Abstract Background The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region. Method We conducted a retrospective review of all consecutive left heart valve replacements in children ( Results One hundred and fourteen patients underwent mitral valve replacement (MVR, aortic valve replacement (AVR or mitral and aortic valve replacements (MAVR. Their ages ranged from 6-18 years (13.3 ± 3.1 years. All patients were in NYHA class III or IV. Median follow up was 9.1 years. MVR was performed in 91 (79.8% patients, AVR in 13 (11.4% and MAVR in 10 (8.8% patients. Tricuspid valve repair was performed concomitantly in 45 (39.5% patients. There were 6 (5.3% early deaths and 6 (5.3% late deaths. Preoperative left ventricular dysfunction (ejection fraction Conclusion Mechanical valve replacement in West African children has excellent outcomes in terms of mortality, valve-related events, and reoperation rate. Preoperative left ventricular dysfunction is the primary determinant of mortality within the first 2 years of valve replacement. The risk of valve-related complications is acceptably low. Anticoagulation is well tolerated with a very low risk of bleeding even in this socioeconomic setting.

  12. St. Jude Medical and CarboMedics Mechanical Heart Valves in the Aortic Position: Comparison of Long-Term Results

    OpenAIRE

    Kandemir, Ozer; Tokmakoglu, Hilmi; Yildiz, Ulku; TEZCANER, Tevfik; Yorgancioglu, A. Cem; Gunay, Ilhan; Suzer, Kaya; Zorlutuna, Yaman

    2006-01-01

    We designed this study to compare long-term results of St. Jude Medical and CarboMedics mechanical heart valves in the aortic position. We retrospectively analyzed the results of 174 consecutive patients who received either a St. Jude (n=80) or a CarboMedics (n=94) mechanical aortic valve from March 1992 through October 2004.

  13. Analysis of the Influence of the Electrical Asynchrony on Regional Mechanics of the Infarcted Left Ventricle Using Electromechanical Heart Models

    Science.gov (United States)

    Liu, Feng; Xia, Ling; Zhang, Xin

    Asynchronous electrical activation, as induced by myocardial infarction, causes various abnormalities in left ventricle function. The influence of the electrical asynchrony on regional mechanics of the left ventricle is simulated using a mechanical heart model and an electrical heart model. The mechanical model accounts for the ventricular geometry, the fiber nature of the myocardial tissue, and the dependency of the activation sequence of the ventricular wall. The electrical model is based on a heart-torso model with realistic geometry, and different action potential waveforms with variables in duration are used to simulate the abnormal electrical activation after myocardial infarction. Regional deformation, strain and stress are calculated during systole phase. The preliminary results show that asynchronous electrical activation, as an important factor, significantly affects regional mechanical performance of the infarcted left ventricle, it indicates heterogeneous contraction pattern and elevated systolic stresses near the injured region. The simulated results are compared with solutions obtained in the literature. This simulation suggests that such coupled heart models can be used to assess the mechanical function of the left ventricle with diseases such as myocardial infarction, and more realistic models of cardiac function are essential for clinical evaluation of heart disease.

  14. Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease Treated by Noninvasive Mechanic Ventilation

    Directory of Open Access Journals (Sweden)

    Zekeriya Küçükdurmaz

    2011-08-01

    Full Text Available Aims: This study aimed to investigate heart rate variability (HRV of patients with severe COPD who are treated by noninvasive mechanic ventilation (NIMV.Patients and Method: Twenty-seven patient (58±8 years, 9 F with severe COPD treated by nocturnal NIMV at home and 23 sex and age matched volunteers (56±8 years, 11 F who has not dyspnea as a control group recruited in the study. Subjects underwent spirometry, blood gas analysis, transthoracic echocardiography, 24 hours ambulatory ECG analysis. Time domain HRV analysis performed from ambulatory ECG records. Results: 52% of patients at NYHA functional class II, 36% at class III, and 12% at class IV when they have been treated by NIMV. Groups were similar for age and sex (p>0.05 for both. Heart rates of patients were higher significantly than controls’ (p0.05. But, systolic pulmonary pressures were higher of COPD group (p<0.01. 24 hours heart rate was higher, and standard deviation of normal R-R intervals (SDNN 24 hours, SDNN night, SDNN day, SDNN index (SDNNI and standard deviation of mean R-R intervals (SDANNI values were lower in COPD group significantly. SDNN was inversely correlated with duration of daily NIMV usage, intensive care unit administration and entubation rate and PaCO2. SDNNI was inversely correlated with functional class, duration of daily NIMV usage, intensive care unit administration rate and PaCO2. Else, SDNNI was correlated with predicted forced vital capacity % (FVC% and predicted forced expiratory volume at 1 second % (FEV1%.Conclusion: Time domain HRV decreases in patients with severe COPD. Decrease is correlated with severity of disease, and it presents in despite of the chronic nocturnal NIMV application. These patients have high risk for cardiovascular morbidity and mortality and should be monitored and manegement for cardiovascular events.

  15. The Renal Nerves in Chronic Heart Failure: Afferent and Efferent Mechanisms

    Directory of Open Access Journals (Sweden)

    Alicia Marie Schiller

    2015-08-01

    Full Text Available The function of the renal nerves has been an area of scientific and medical interest for many years. The recent advent of a minimally invasive catheter-based method of renal denervation has renewed excitement in understanding the afferent and efferent actions of the renal nerves in multiple diseases. While hypertension has been the focus of much this work, less attention has been given to the role of the renal nerves in the development of chronic heart failure (CHF. Recent studies from our laboratory and those of others implicate an essential role for the renal nerves in the development and progression of CHF. Using a rabbit tachycardia model of CHF and surgical unilateral renal denervation, we provide evidence for both renal efferent and afferent mechanisms in the pathogenesis of CHF. Renal denervation prevented the decrease in renal blood flow observed in CHF while also preventing increases in Angiotensin-II receptor protein in the microvasculature of the renal cortex. Renal denervation in CHF also reduced physiological markers of autonomic dysfunction including an improvement in arterial baroreflex function, heart rate variability, and decreased resting cardiac sympathetic tone. Taken together, the renal sympathetic nerves are necessary in the pathogenesis of CHF via both efferent and afferent

  16. Mitochondrial damage: An important mechanism of ambient PM2.5 exposure-induced acute heart injury in rats

    International Nuclear Information System (INIS)

    Highlights: • PM2.5 induces heart mitochondrial morphological damage of rats. • Mitochondrial fission/fusion gene expression is important regulation mechanism. • Proinflammatoy cytokine level changes are accompanied with mitochondrial damage. • Alterations in oxidative stress and calcium homeostasis are focused on. - Abstract: Epidemiological studies suggested that ambient fine particulate matter (PM2.5) exposure was associated with cardiovascular disease. However, the underlying mechanism, especially the mitochondrial damage mechanism, of PM2.5-induced heart acute injury is still unclear. In this study, the alterations of mitochondrial morphology and mitochondrial fission/fusion gene expression, oxidative stress, calcium homeostasis and inflammation in hearts of rats exposed to PM2.5 with different dosages (0.375, 1.5, 6.0 and 24.0 mg/kg body weight) were investigated. The results indicated that the PM2.5 exposure induced pathological changes and ultra-structural damage in hearts such as mitochondrial swell and cristae disorder. Furthermore, PM2.5 exposure significantly increased specific mitochondrial fission/fusion gene (Fis1, Mfn1, Mfn2, Drp1 and OPA1) expression in rat hearts. These changes were accompanied by decreases of activities of superoxide dismutase (SOD), Na+K+-ATPase and Ca2+-ATPase and increases of levels of malondialdehyde (MDA), inducible nitric oxide synthase (iNOS) and nitric oxide (NO) as well as levels of pro-inflammatory mediators including TNF-α, IL-6 and IL-1β in rat hearts. The results implicate that mitochondrial damage, oxidative stress, cellular homeostasis imbalance and inflammation are potentially important mechanisms for the PM2.5-induced heart injury, and may have relations with cardiovascular disease

  17. Glycyrrhizic Acid Reduces Heart Rate and Blood Pressure by a Dual Mechanism

    OpenAIRE

    Kailash Singh; Aung Moe Zaw; Revathi Sekar; Ahuja Palak; Allam, Ahmed A.; Jamaan Ajarem; Chow, Billy K. C.

    2016-01-01

    Beta adrenergic receptors are crucial for their role in rhythmic contraction of heart along with their role in the pathological conditions such as tachycardia and high risk of heart failure. Studies report that the levels of beta-1 adrenergic receptor tend to decrease by 50%, whereas, the levels of beta-2 adrenergic receptor remains constant during the risk of heart failure. Beta blockers—the antagonistic molecules for beta-adrenergic receptors, function by slowing the heart rate, which there...

  18. Cardiac Embryology and Molecular Mechanisms of Congenital Heart Disease: A Primer for Anesthesiologists.

    Science.gov (United States)

    Kloesel, Benjamin; DiNardo, James A; Body, Simon C

    2016-09-01

    Congenital heart disease is diagnosed in 0.4% to 5% of live births and presents unique challenges to the pediatric anesthesiologist. Furthermore, advances in surgical management have led to improved survival of those patients, and many adult anesthesiologists now frequently take care of adolescents and adults who have previously undergone surgery to correct or palliate congenital heart lesions. Knowledge of abnormal heart development on the molecular and genetic level extends and improves the anesthesiologist's understanding of congenital heart disease. In this article, we aim to review current knowledge pertaining to genetic alterations and their cellular effects that are involved in the formation of congenital heart defects. Given that congenital heart disease can currently only occasionally be traced to a single genetic mutation, we highlight some of the difficulties that researchers face when trying to identify specific steps in the pathogenetic development of heart lesions. PMID:27541719

  19. Doppler derived gradient of ST Jude Mechanical Prosthesis, early postoperative assessment

    International Nuclear Information System (INIS)

    Objective: To determine the doppler derived mean gradients of St Jude mechanical prosthesis in early postoperative period in patients undergoing valve replacement at a tertiary care cardiac centre. Methods: Medical records of 190 consecutive patients who underwent 233 mitral, aortic or dual (mitral and aortic) valve replacement by St Jude bileaflet mechanical prosthesis at Tabba Heart Institute, between March 2006 to December 2008 were reviewed. Doppler derived mean gradients were assessed predischarge and recorded. Results: There were 98 (51.5%) males and 92 (48.5%) females in the study cohort. The mean age was 40 +- 14 years. Of the total, 101 (53%) had mitral, 46 (24.2%) had aortic and 43 (22.6%) patients had dual valve replacement. Doppler derived mean gradient was assessed across 144 mitral and 89 aortic St Jude mechanical prosthesis. Doppler derived mean gradient for St Jude mitral prosthesis was 3.5 mm Hg and for St Jude aortic prosthesis was 10.2 mm Hg. Conclusions: The study determines baseline gradients across mitral and aortic St Jude mechanical prosthesis in our population. These can be used as reference gradients to assess St Jude prosthetic valve function in patients who did not have early postoperative doppler assessment. (author)

  20. THE STUDY OF PRODUCTION AND MECHANISM OF ANTIPHOSPHOLIPID ANTIBODIES IN PATIENTS WITH CORONARY HEART DISEASE

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To assess whether there was strong association between antiphospholipid antibodies(APA) and coronary heart disease(CHD), to study the environmental factors of APA production and APA pathogenic mechanism in patients with CHD.Methods Blood samples from 76 patients with CHD and 30 controls were tested for anticardiolipin antibodies IgG(ACA-IgG),human cytomegalovirus IgG,IgM(HCMV-IgG,IgM) by enzyme-link immunosorbant assay(ELISA) and 6-keto-PGF1a,endothelin(ET) by radioimmunoassay(RIA).Results A total of 27 patients(35.53%) were ACA positive in 76, as compared to 2 of 30(6.67%) healthy individuals, P<0.05. There was no difference in ACA among acute myocardial infarction(AMI,39.13%), old myocardial infarction(OMI,26.53%), unstable angina pectoris(UA,38.40%), P>0.05. The number of ACA positive subjects was higher in HCMV infection patients with CHD than no HCMV infectious patients with CHD. There was no PGI2 and ET level difference between ACA-IgG positive and negative CHD.Conclusion There are strong association between APA and CHD. The HCMV infection may be an environmental factor of APA production in CHD patients with raised ACA. The alteration of PGI2 and ET are not the pathogenic mechanism of ACA in patients with CHD.

  1. the Multitargets Pharmacological Mechanism of Qishenkeli Acting on the Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Yong Wang

    2012-01-01

    Full Text Available In this paper, we present a case study of Qishenkeli (QSKL to research TCM’s underlying molecular mechanism, based on drug target prediction and analyses of TCM chemical components and following experimental validation. First, after determining the compositive compounds of QSKL, we use drugCIPHER-CS to predict their potential drug targets. These potential targets are significantly enriched with known cardiovascular disease-related drug targets. Then we find these potential drug targets are significantly enriched in the biological processes of neuroactive ligand-receptor interaction, aminoacyl-tRNA biosynthesis, calcium signaling pathway, glycine, serine and threonine metabolism, and renin-angiotensin system (RAAS, and so on. Then, animal model of coronary heart disease (CHD induced by left anterior descending coronary artery ligation is applied to validate predicted pathway. RAAS pathway is selected as an example, and the results show that QSKL has effect on both rennin and angiotensin II receptor (AT1R, which eventually down regulates the angiotensin II (AngII. Bioinformatics combing with experiment verification can provide a credible and objective method to understand the complicated multitargets mechanism for Chinese herbal formula.

  2. Physiologic benefits of pulsatile perfusion during mechanical circulatory support for the treatment of acute and chronic heart failure in adults.

    Science.gov (United States)

    Guan, Yulong; Karkhanis, Tushar; Wang, Shigang; Rider, Alan; Koenig, Steven C; Slaughter, Mark S; El Banayosy, Aly; Undar, Akif

    2010-07-01

    A growing population experiencing heart failure (100,000 patients/year), combined with a shortage of donor organs (less than 2200 hearts/year), has led to increased and expanded use of mechanical circulatory support (MCS) devices. MCS devices have successfully improved clinical outcomes, which are comparable with heart transplantation and result in better 1-year survival than optimal medical management therapies. The quality of perfusion provided during MCS therapy may play an important role in patient outcomes. Despite demonstrated physiologic benefits of pulsatile perfusion, continued use or development of pulsatile MCS devices has been widely abandoned in favor of continuous flow pumps owing to the large size and adverse risks events in the former class, which pose issues of thrombogenic surfaces, percutaneous lead infection, and durability. Next-generation MCS device development should ideally implement designs that offer the benefits of rotary pump technology while providing the physiologic benefits of pulsatile end-organ perfusion.

  3. Biomedical engineering support. Progress report, August 15, 1976--May 15, 1977. [Testing of radioisotope-powered mechanical heart in calves

    Energy Technology Data Exchange (ETDEWEB)

    Kolff, W.J.; Olsen, D.B.

    1977-05-01

    A total of 41 ERDA Artificial Hearts have been implanted since the initiation of the ERDA Artificial Heart Program. During the period covered by this report, August 15, 1976 to May 15, 1977, 8 total heart replacement experiments have been performed in calves using the ERDA Blood Pump powered by an electric motor implanted in the abdomen. The average survival time for these 8 experiments was 162 hours (6.8 days). Significant advances have been achieved in the mechanical, surgical, and physiological areas. This year the oil-filled blood pump called the Implantable Version of the Bench Model (IVBM) was delivered by Westinghouse for in vivo studies at the University of Utah. Experience is being gained in the assembling and surgical implantation of this device. Several of these systems have been implanted and a 37 day survivor has been achieved.

  4. Transient pressure at closing of a monoleaflet mechanical heart valve prosthesis: mounting compliance effect.

    Science.gov (United States)

    Wu, Z J; Gao, B Z; Hwang, N H

    1995-09-01

    An in vitro experimental study was performed to investigate the mounting compliance effect on the occluder closing dynamics and the transient pressure at the closing of the mitral Medtronic Hall (MH) mechanical heart valve (MHV). The closing velocity and the transient pressure were simultaneously measured at heart rates of 70, 90, 120, and 140 beats/minute with cardiac outputs of 5.0, 6.0, 7.5, and 8.5 liters/minute, respectively. The experiment was conducted under simulated physiologic ventricular and aortic pressures in a pulsatile mock flow loop. The characteristics of the transient pressure were investigated by detailed mapping of the transient pressure field in the atrial chamber using high frequency pressure transducers. Simultaneous measurements of the occluder closing velocity and the transient pressure around the seat stop of the MH showed that the transient pressure generated on the inflow side dropped below the vapor pressure of liquid during the occluder's sudden deceleration at closing. The amplitude of the transient pressure reduction (TR) was proportional to the occluder approaching velocity. The development of the transient pressure in the rigid and flexible mountings were significantly different. In the rigid mounting (RM), the pressure was reduced below the liquid's vapor pressure and maintained below -350 mmHg for approximately 180 microseconds. Strong signals of high frequency pressure oscillations (HPO) were recorded in the transient pressure traces. The timing of the HPO was found to be consistent with that of the cavitation bubble collapse as observed by others. In the flexible mounting (FM), TR also occurred, but recovered quickly and was followed immediately by a positive pressure spike. Relatively weak HPO appeared in the transient pressure trace. The mapping of the transient pressure field showed that both the transient pressure reduction (on the major orifice side) or rise (on the minor orifice side) as well as the HPO were locally

  5. Válvula cardíaca de carbono de duplo folheto Biplus: projeto e desenvolvimento Biplus bileaflet carbon cardiac valve: project and development

    Directory of Open Access Journals (Sweden)

    Hélio Pereira de Magalhães

    1996-12-01

    uso clínico. CONCLUSÕES: A válvula de dois folhetos Biplus apresentou-se com desenho adequado para receber o material biológico e, também, para funcionar com batente de silicone, deixando a válvula bastante silenciosa, para melhor conforto do paciente.INTRODUCTION: After the development of carbon cardiac disc valve covered with heterologous pericardium with good clinical results after two years, the authors developed the first brazilian carbon bileaflet valve. The finality was to have a valve with low level of noise, recovered with biological material for improving the annulus valve healing and reduce the exposed synthetic material in blood stream. Linning the valve with biologic material is a tentative to reduce the morbidity and mortality on respect of thrombosis, thromboembolism, reoperations and minor use of anticoagulants to reduce the haemorrhagic events. Some principles were established on hybrid valve: durable mechanical system, points of contact without biologic material, use of biologic material with minor organic reaction, preferential closing system with superposition on a track seat and loose points for accept biologic material limited growth. MATERIAL AND METHODS: The bileaflet valve has horizontal closing with points of articulation in the internal face of valve ring, made of CARBOLITE (hardened polymeric carbon. The valve is made in three models: only in carbon (equal to other valves, one model recovered with biologic material and a model with silicone elastomer track seat recovered with heterologous pericardium, intended to be noiseless, conserved in glycerin. There are two aortic patients with the second model with two and three months of evolution with oral anticoagulations. RESULTS: The cases have a short time of evolution with good results. The model with silicone elastomer track seat is in fatigue test system and does not have any rupture after 30 days, equivalent to 1.4 years of clinic use. CONCLUSIONS: The Biplus valve shows adequate

  6. Studies of the myocardial uptake and excretion mechanisms of a novel 99mTc heart perfusion agent

    International Nuclear Information System (INIS)

    Introduction: 99mTc-TMEOP is a novel heart perfusion radiotracer exhibiting high initial and persistent heart uptake associated with rapid blood and liver clearance. This study aimed at determining the mechanisms of myocardial localization and fast liver clearance of 99mTc-TMEOP. Methods: Subcellular distribution of 99mTc-TMEOP was determined in excised rat heart tissue by differential centrifugation. The effect of cyclosporin A on the pharmacokinetic behaviour of 99mTc-TMEOP was evaluated by both ex vivo biodistribution and in vivo planar imaging studies. Results: Subcellular distribution studies showed that more than 73% of 99mTc-TMEOP was associated with the mitochondrial fraction. Comparison with subcellular distribution of 99mTc-sestamibi showed no significant difference in the mitochondrial accumulation between the two tracers. Biodistribution studies in the presence of cyclosporin A revealed an increase in kidneys and liver uptake of 99mTc-TMEOP, suggesting the involvement of multidrug resistance transporters in determining its pharmacokinetic profile. Conclusions: The heart uptake mechanism of 99mTc-TMEOP is similar to that of the other reported monocationic 99mTc cardiac agents and is associated with its accumulation in the mitochondria. Cyclosporin A studies indicate that the fast liver and kidney clearance kinetics is mediated by P-glycoprotein (Pgp), supporting the potential interest of this radiotracer for imaging Pgp function associated with multidrug-resistant tumours.

  7. Role of thrombus precursor protein in assessment of anticoagulation in patients with atrial fibrillation after mechanical heart valve replacement

    Institute of Scientific and Technical Information of China (English)

    秦川; 肖颖彬; 陈林; 王学锋; 钟前进

    2004-01-01

    Objective: To explore the role of thrombus precursor protein (TpP) in assessment of anticoagulation and predict the risk of thromboembolism in the patients with atrial fibrillation (AF) after mechanical heart valve replacement. Methods: TpP plasma concentration and international normalization ratio (INR) were measured in 45 patients with atrial fibrillation and 45 patients with sinus rhythm both after mechanical heart valve replacement. Twenty patients with non-valvular heart diseases were selected as the control. Furthermore, the patients with AF were divided into groups based on different TpP plasma concentration and TpP plasma concentration and INR were analyzed. Results: After mechanical heart valve replacement, those with AF had higher TpP plasma concentration than those with sinus rhythm. It was found that discordancy existed between INR and TpP plasma concentration in the patients with AF. There were 28 AF patients with TpP plasma concentration lower than 6 μg/ml and without bleeding, who might be at the optimal anticoagulant state. The 95% confidence of the mean INR value was 1.90-2.30 in these patients and TpP plasma concentration was between 2.84-5.74 μg/ml. Conclusion: Patients with AF might face higher risk of thromboembolism after mechanical valve replacement; INR between 1.90-2.30 and TpP plasma concentration between 2.84-6 μg/ml might be the optimal anticoagulant range for patients with AF after mechanical valve replacement.

  8. Duration of heart failure and the risk of atrial fibrillation: different mechanisms at different times?

    OpenAIRE

    Rankin, A C; Workman, A.J.

    2009-01-01

    Chronic heart failure increases the risk of atrial fibrillation (AF), with the prevalence of AF paralleling the severity of heart failure.1 Factors that underlie this increased susceptibility to AF may include electrical, structural, and neurohumoral changes.2 In AF, it is recognized that atrial electrophysiological remodelling occurs and contributes to the perpetuation of the arrhythmia, most notably the decrease of effective refractory period (ERP) which predisposes to re-entry by shortenin...

  9. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors

    OpenAIRE

    Bruno-Pierre Dubé; Piergiuseppe Agostoni; Pierantonio Laveneziana

    2016-01-01

    Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology. Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators o...

  10. Cavitation phenomena in mechanical heart valves: studied by using a physical impinging rod system.

    Science.gov (United States)

    Lo, Chi-Wen; Chen, Sheng-Fu; Li, Chi-Pei; Lu, Po-Chien

    2010-10-01

    When studying mechanical heart valve cavitation, a physical model allows direct flow field and pressure measurements that are difficult to perform with actual valves, as well as separate testing of water hammer and squeeze flow effects. Movable rods of 5 and 10 mm diameter impinged same-sized stationary rods to simulate squeeze flow. A 24 mm piston within a tube simulated water hammer. Adding a 5 mm stationary rod within the tube generated both effects simultaneously. Charged-coupled device (CCD) laser displacement sensors, strobe lighting technique, laser Doppler velocimetry (LDV), particle image velocimetry (PIV) and high fidelity piezoelectric pressure transducers measured impact velocities, cavitation images, squeeze flow velocities, vortices, and pressure changes at impact, respectively. The movable rods created cavitation at critical impact velocities of 1.6 and 1.2 m/s; squeeze flow velocities were 2.8 and 4.64 m/s. The isolated water hammer created cavitation at 1.3 m/s piston speed. The combined piston and stationary rod created cavitation at an impact speed of 0.9 m/s and squeeze flow of 3.2 m/s. These results show squeeze flow alone caused cavitation, notably at lower impact velocity as contact area increased. Water hammer alone also caused cavitation with faster displacement. Both effects together were additive. The pressure change at the vortex center was only 150 mmHg, which cannot generate the magnitude of pressure drop required for cavitation bubble formation. Cavitation occurred at 3-5 m/s squeeze flow, significantly different from the 14 m/s derived by Bernoulli's equation; the temporal acceleration of unsteady flow requires further study. PMID:20490686

  11. A novel iterative reconstruction algorithm allows reduced dose multidetector-row CT imaging of mechanical prosthetic heart valves

    OpenAIRE

    Habets, Jesse; Symersky, Petr; de Mol, Bas A. J. M.; Willem P Th M Mali; Leiner, Tim; Budde, Ricardo P.J.

    2011-01-01

    Multidetector-row CT is promising for prosthetic heart valve (PHV) assessment but retrospectively ECG-gated scanning has a considerable radiation dose. Recently introduced iterative reconstruction (IR) algorithms may enable radiation dose reduction with retained image quality. Furthermore, PHV image quality on the CT scan mainly depends on extent of PHV artifacts. IR may decrease streak artifacts. We compared image noise and artifact volumes in scans of mechanical PHVs reconstructed with conv...

  12. Progressive Left Ventricular Hypertrophy after Heart Transplantation: Insights and Mechanisms Suggested by Multimodal Images.

    Science.gov (United States)

    Ananthasubramaniam, Karthik; Garikapati, Kiran; Williams, Celeste T

    2016-02-01

    Immunosuppression is the typical measure to prevent rejection after heart transplantation. Although rejection is the usual cause of cardiac hypertrophy, numerous other factors warrant consideration. Calcineurin inhibitors rarely cause hypertrophic cardiomyopathy; the few relevant reports have described children after orthotopic kidney or liver transplantation. We present the case of a 73-year-old woman, an asymptomatic orthotopic heart transplantation patient, in whom chronic immunosuppression with prednisone and cyclosporine apparently caused a phenotype of hypertrophic cardiomyopathy. The natural course of her midapical hypertrophy was revealed by single-photon-emission computed tomography, positron-emission tomography, and 2-dimensional echocardiography. Clinicians and radiographers should be alert to progressive left ventricular hypertrophy and various perfusion patterns in heart transplantation patients even in the absence of underlying coronary artery disease. Toward this end, we recommend that advanced imaging methods be used to their fullest extent. PMID:27047289

  13. Experimental investigations on the fluid-mechanics of an electrospun heart valve by means of particle image velocimetry.

    Science.gov (United States)

    Del Gaudio, Costantino; Gasbarroni, Pier Luca; Romano, Giovanni Paolo

    2016-12-01

    End-stage failing heart valves are currently replaced by mechanical or biological prostheses. Both types positively contribute to restore the physiological function of native valves, but a number of drawbacks limits the expected performances. In order to improve the outcome, tissue engineering can offer an alternative approach to design and fabricate innovative heart valves capable to support the requested function and to promote the formation of a novel, viable and correctly operating physiological structure. This potential result is particularly critical if referred to the aortic valve, being the one mainly exposed to structural and functional degeneration. In this regard, the here proposed study presents the fabrication and in vitro characterization of a bioresorbable electrospun heart valve prosthesis using the particle image velocimetry technique either in physiological and pathological fluid dynamic conditions. The scaffold was designed to reproduce the aortic valve geometry, also mimicking the fibrous structure of the natural extracellular matrix. To evaluate its performances for possible implantation, the flow fields downstream the valve were accurately investigated and compared. The experimental results showed a correct functionality of the device, supported by the formation of vortex structures at the edge of the three cusps, with Reynolds stress values below the threshold for the risk of hemolysis (which can be comprised in the range 400-4000N/m(2) depending on the exposure period), and a good structural resistance to the mechanical loads generated by the driving pressure difference.

  14. On-X Heart Valve Prosthesis: Numerical Simulation of Hemodynamic Performance in Accelerating Systole.

    Science.gov (United States)

    Mirkhani, Nima; Davoudi, Mohammad Reza; Hanafizadeh, Pedram; Javidi, Daryoosh; Saffarian, Niloofar

    2016-09-01

    Numerical simulation of the bileaflet mechanical heart valves (BMHVs) has been of interest for many researchers due to its capability of predicting hemodynamic performance. A lot of studies have tried to simulate this three-dimensional complex flow in order to analyze the effect of different valve designs on the blood flow pattern. However, simplified models and prescribed motion for the leaflets were utilized. In this paper, transient complex blood flow in the location of ascending aorta has been investigated in a realistic model by fully coupled simulation. Geometry model for the aorta and the replaced valve is constructed based on the medical images and extracted point clouds. A 23-mm On-X Medical BMHV as the new generation design has been selected for the flow field analysis. The two-way coupling simulation is conducted throughout the accelerating phase in order to obtain valve dynamics in the opening process. The complex flow field in the hinge recess is captured precisely for all leaflet positions and recirculating zones and elevated shear stress areas have been observed. Results indicate that On-X valve yields relatively less transvalvular pressure gradient which would lower cardiac external work. Furthermore, converging inlet leads to a more uniform flow and consequently less turbulent eddies. However, the leaflets cannot open fully due to middle diffuser-shaped orifice. In addition, asymmetric butterfly-shaped hinge design and converging orifice leads to better hemodynamic performance. With the help of two-way fluid solid interaction simulation, leaflet angle follows the experimental trends more precisely rather than the prescribed motion in previous 3D simulations. PMID:27164902

  15. Anemia and iron deficiency in heart failure : mechanisms and therapeutic approaches

    NARCIS (Netherlands)

    van Veldhuisen, Dirk J.; Anker, Stefan D.; Ponikowski, Piotr; Macdougall, Iain C.

    2011-01-01

    Anemia and iron deficiency are common in patients with heart failure (HF), and are associated with worse symptoms and adverse outcomes in this population. Although the two can occur together, anemia in HF is often not caused by iron deficiency, and iron deficiency can be present without causing anem

  16. Age-Dependent Changes in Geometry, Tissue Composition and Mechanical Properties of Fetal to Adult Cryopreserved Human Heart Valves.

    Science.gov (United States)

    van Geemen, Daphne; Soares, Ana L F; Oomen, Pim J A; Driessen-Mol, Anita; Janssen-van den Broek, Marloes W J T; van den Bogaerdt, Antoon J; Bogers, Ad J J C; Goumans, Marie-José T H; Baaijens, Frank P T; Bouten, Carlijn V C

    2016-01-01

    There is limited information about age-specific structural and functional properties of human heart valves, while this information is key to the development and evaluation of living valve replacements for pediatric and adolescent patients. Here, we present an extended data set of structure-function properties of cryopreserved human pulmonary and aortic heart valves, providing age-specific information for living valve replacements. Tissue composition, morphology, mechanical properties, and maturation of leaflets from 16 pairs of structurally unaffected aortic and pulmonary valves of human donors (fetal-53 years) were analyzed. Interestingly, no major differences were observed between the aortic and pulmonary valves. Valve annulus and leaflet dimensions increase throughout life. The typical three-layered leaflet structure is present before birth, but becomes more distinct with age. After birth, cell numbers decrease rapidly, while remaining cells obtain a quiescent phenotype and reside in the ventricularis and spongiosa. With age and maturation-but more pronounced in aortic valves-the matrix shows an increasing amount of collagen and collagen cross-links and a reduction in glycosaminoglycans. These matrix changes correlate with increasing leaflet stiffness with age. Our data provide a new and comprehensive overview of the changes of structure-function properties of fetal to adult human semilunar heart valves that can be used to evaluate and optimize future therapies, such as tissue engineering of heart valves. Changing hemodynamic conditions with age can explain initial changes in matrix composition and consequent mechanical properties, but cannot explain the ongoing changes in valve dimensions and matrix composition at older age.

  17. When a Mechanical Valve Goes Freestyle: A Patient Tailored Valve-In-Valve Implantation.

    Science.gov (United States)

    François, J; Cathenis, K; Hamerlijnck, R

    2015-01-01

    In case of a redo operation after a full root replacement there are two possible options: replacing the entire root or performing a more conservative valve-in-valve implantation. Regarding the relatively high morbidity and mortality of a redo root replacement, the valve-in-valve implantation is the preferred choice if technically feasible. We present the case of a valve-in-valve implantation with a St. Jude mechanical valve in a Medtronic bioprosthesis in a 57-year old man. Follow-up echocardiography after 1 month showed a mean gradient of 17 mmHg and no paravalvular leakage. The combination of a St. Jude bileaflet mechanical valve implanted in a Freestyle root prosthesis has not been described. This case shows that patient tailored treatment with a St. Jude bileaflet mechanical valve in a Freestyle aortic root valve can be safely performed and might be the preferred choice for younger patients, if technically feasible. PMID:26560005

  18. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  19. Mechanisms of oxidative stress and myocardial protection during open-heart surgery

    Directory of Open Access Journals (Sweden)

    Nikolaos G Baikoussis

    2015-01-01

    Full Text Available Cold heart protection via cardioplegia administration, limits the amount of oxygen demand. Systemic normothermia with warm cardioplegia was introduced due to the abundance of detrimental effects of hypothermia. A temperature of 32-33°C in combination with tepid blood cardioplegia of the same temperature appears to be protective enough for both; heart and brain. Reduction of nitric oxide (NO concentration is in part responsible for myocardial injury after the cardioplegic cardiac arrest. Restoration of NO balance with exogenous NO supplementation has been shown useful to prevent inflammation and apoptosis. In this article, we discuss the "deleterious" effects of the oxidative stress of the extracorporeal circulation and the up-to-date theories of "ideal′′ myocardial protection.

  20. Omentum-derived stromal cells improve myocardial regeneration in pig post-infarcted heart through a potent paracrine mechanism

    International Nuclear Information System (INIS)

    Cell-based therapy could be a valid option to treat myocardial infarct (MI). Adipose-derived stromal cells (ADStCs) have demonstrated tissue regenerative potential including cardiomyogenesis. Omentum is an extremely rich source of visceral fat and its accumulation seems to correlate with cardiovascular diseases. We investigated the capacity of human fat Omentum-derived StCs (FOStCs) to affect heart function upon acute infarct in pigs induced by permanent ligation of the anterior interventricular artery (IVA). We demonstrated for the first time that the local injection of 50 x 106 of FOStCs ameliorates the functional parameters of post-infarct heart. Most importantly, histology of FOStCs treated hearts demonstrated a substantial improvement of cardiomyogenesis. In culture, FOStCs produced an impressive number and amount of angiogenic factors and cytokines. Moreover, the conditioned medium of FOStCs (FOStCs-CM) stimulates in vitro cardiac endothelial cells (ECs) proliferation and vascular morphogenesis and inhibits monocytes, EC activation and cardiomyocyte apoptosis. Since FOStCs in vivo did not trans-differentiate into cardiomyocyte-like cells, we conclude that FOStCs efficacy was presumably mediated by a potent paracrine mechanism involving molecules that concomitantly improved angiogenesis, reduced inflammation and prevented cardiomyocytes death. Our results highlight for the first time the important role that human FOStCs may have in cardiac regeneration.

  1. Does low-frequency variability of heart period reflect a specific parasympathetic mechanism?

    Science.gov (United States)

    Grasso, R; Schena, F; Gulli, G; Cevese, A

    1997-03-19

    Low frequency (LF, approximately 0.1 Hz) spontaneous oscillations of heart period in humans have been attributed to and correlated with the sympathetic efferent control of the heart. However, this interpretation is controversial, because sympathetic blockade does not suppress these oscillations, while parasympathetic blockade strongly affects them. The sympathetic origin of LF of arterial pressure, on the contrary, has been convincingly demonstrated. Four 10 min cycle-by-cycle time series of R-R interval (RR), and systolic (SAP) and diastolic (DAP) arterial pressure were produced by automatic analysis of data obtained with non-invasive methods in 10 healthy humans during supine rest and while standing, both before and after beta 1-selective blockade (atenolol). Time series were analysed by autoregressive transfer function analysis. beta-blockade failed to induce systematic changes on the power of the LF peak of RR, in any condition. The coherence between RR and SAP in the same region remained high (0.77 +/- 0.03) and a constantly negative phase (approximately 50-60 degrees, corresponding to a delay of 1-2 heart beats of RR on SAP) was always seen. beta-blockade decreased the power of the LF peak of SAP, increased the transfer function gain between SAP and RR at LF, and the HF power of RR. We conclude that LF oscillations of RR are not directly generated by the sympathetic drive to the heart but reflect mainly the parasympathetic activity. The results suggest that the LF oscillations of the vagal outflow, and of RR, are generated by the baroreceptor reflex, driven by sympathetically-induced blood pressure LF waves. PMID:9089536

  2. Experimental Heart Failure Induces Alterations of the Lung Proteome - Insight into Molecular Mechanisms

    Directory of Open Access Journals (Sweden)

    Christoph Birner

    2014-03-01

    Full Text Available Background: Heart failure (CHF is characterized by dyspnea and pulmonary changes. The underlying molecular adaptations are unclear, but might provide targets for therapeutic interventions. We therefore conceived a study to determine molecular changes of early pulmonary stress failure in a model of tachycardia-induced heart failure. Methods: CHF was induced in rabbits by progessive right ventricular pacing (n=6. Invasive blood pressure measurements and echocardiography were repeatedly performed. Untreated animals served as controls (n=6. Pulmonary tissue specimens were subjected to two-dimensional gel electrophoresis, and differentially expressed proteins were identified by mass spectrometry. Selected proteins were validated by Western Blot analysis and localized by immunohistochemical staining. Results: CHF animals were characterized by significantly altered functional, morphological, and hemodynamic parameters. Upon proteomic profiling, a total of 33 proteins was found to be differentially expressed in pulmonary tissue of CHF animals (18 up-regulated, and 15 down-regulated belonging to 4 functional groups: 1. proteins involved in maintaining cytoarchitectural integrity, 2. plasma proteins indicating impaired alveolar-capillary permeability, 3. proteins with antioxidative properties, and 4. proteins participating in the metabolism of selenium compounds Conclusion: Experimental heart failure profoundly alters the pulmonary proteome. Our results supplement the current knowledge of pulmonary stress failure by specifying its molecular fundament.

  3. Evaluation of left ventricular mechanical dyssynchrony in chronic heart failure patients by two-dimensional speckle tracking imaging.

    Science.gov (United States)

    Jiang, Feng-Xia; Guo, Rui-Qiang; Chen, Jin-Ling

    2013-07-01

    The purpose of this study was to evaluate left ventricular mechanical dyssynchrony (LVMD) in chronic heart failure (CHF) patients using two-dimensional speckle tracking imaging (2D-STI), and also to compare the usefulness of three patterns of myocardial deformation in mechanical dyssynchrony assessment. Furthermore, the relationships between left ventricular ejection fraction (LVEF), QRS duration (QRSd), and LVMD were explored. In total, 78 patients and 60 healthy individuals (group 3) were enrolled. The patients were classified into two subgroups: LVEF≤35% (group 1), 35%0.05). CHF patients have different extents of LVMD. Longitudinal deformation shows the best detectability of dyssynchrony motion. Left ventricular systolic function was closely related to mechanical dyssynchrony, whereas QRSd showed no significant correlation.

  4. Metformin in patients with ischemic heart disease and type 2 diabetes mellitus: mechanism of action and clinical efficiency

    Directory of Open Access Journals (Sweden)

    E N Kravchuk

    2013-03-01

    Full Text Available Diabetes mellitus is one of the leading causes of death in modern society, primarily due to its cardiovascular complications. This factor drives search for novel pharmacologic agents to affect not only glycemic levels, but also the cardiovascular prognosis in diabetic patients with ischemic heart disease. Recent studies demonstrate that aside from basic blood glucose lowering action, metformin shows beneficial influence on blood rheology and vascular tone, hemostasis, oxidative stress, lipid spectrum and delivers and an ant-ischemic effect. Here we review clinical and experimental evidence on cardio- and vasoprotective effects of metformin, highlighting their molecular mechanisms.

  5. ATP-loaded Liposomes Effectively Protect Mechanical Functions of the Myocardium from Global Ischemia in an Isolated Rat Heart Model

    OpenAIRE

    Verma, D.D.; Levchenko, T.S.; Bernstein, E.A.; Torchilin, V.P

    2005-01-01

    ATP-loaded liposomes (ATP-L) infused into Langendorff-instrumented isolated rat hearts protect the mechanical functions of the myocardium during ischemia/reperfusion. The left ventricular developed pressure (LVDP) at the end of the reperfusion in the ATP-L group recovered to 72% of the baseline (preservation of the systolic function) compared to 26%, 40%, and 51% in the groups treated with Krebs-Henseleit (KH) buffer, empty liposomes (EL), and free ATP (F-ATP), respectively. The ATP-L-treated...

  6. PERIPHERAL VENO-ARTERIAL ECMO AS MECHANICAL CIRCULATORY SUPPORT BEFORE HEART TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    E. A. Spirina

    2013-01-01

    Full Text Available Aim of our clinical study was evaluation own initial experience of high-urgency ortotopic heart transplantation (OHT in recipients, who were bridged on peripheral Vena-Arterial Extracorporeal Membrane Oxygenation (VA ECMO. Materials and methods. In this study was included 17 patients (14/3 M/F, age 16–66 (40.1 ± 4.2 yrs who underwent OHT while on peripheral ECMO support. In all cases we used peripheral surgical can- nulation technique via femoral vessels – arterial cannula 15–19 Fr, venous cannula – 21–25 Fr, arterial cannula or vascular catheter 8–10 Fr for anterograde leg’s perfusion. Results. Duration Vena-Arterial Extracorporeal Membrane Oxygenation before OHT was 81 ± 17 h. VA ECMO support was blood flow 4.8 ± 0.6 l/min or 2.63 ± 0/04 l/min/m2, gas flow 4.8 ± 0.6 l/min, FiO2 0.86 ± 0.07. Vena-Arterial Extracorporeal Membrane Oxygenation support was continued in “protective mode” (blood flow 1.9 ± 0.2 l/min 4.3 ± 0.5 days after OHT. Thirteen pa- tients (76.4% were weaned from VA ECMO successfully and survived to be discharged. ICU and hospital LOS after orthotopic heart transplantation was respectively 6.7 ± 0.8 and 32.3 ± 4.6 days in group of survived patients. The reasons of a lethal outcome (n = 4, 23.5% were sepsis and multiorgan failure (n = 3, sudden cardiac arrest (n = 1. Conclusion. Vena-Arterial Extracorporeal Membrane Oxygenation is a favorable short-term method of circulatory support in patients who needed in high-urgency heart transplantation. 

  7. PERIPHERAL VENO-ARTERIAL ECMO AS MECHANICAL CIRCULATORY SUPPORT BEFORE HEART TRANSPLANTATION

    OpenAIRE

    E. A. Spirina; R. S. Saitgareev; D. V. Shumakov; V. M. Zakharevitch; V. V. Slobodyannik; M. G. Minina; V. V. Pchelnikov; O. A. Eremeeva; P. G. Lavrenov

    2013-01-01

    Aim of our clinical study was evaluation own initial experience of high-urgency ortotopic heart transplantation (OHT) in recipients, who were bridged on peripheral Vena-Arterial Extracorporeal Membrane Oxygenation (VA ECMO). Materials and methods. In this study was included 17 patients (14/3 M/F, age 16–66 (40.1 ± 4.2 yrs)) who underwent OHT while on peripheral ECMO support. In all cases we used peripheral surgical can- nulation technique via femoral vessels – arterial cannula 15–19 Fr, venou...

  8. Numerical simulation of the non-Newtonian blood flow through a mechanical aortic valve. Non-Newtonian blood flow in the aortic root

    Science.gov (United States)

    De Vita, F.; de Tullio, M. D.; Verzicco, R.

    2016-04-01

    This work focuses on the comparison between Newtonian and non-Newtonian blood flows through a bileaflet mechanical heart valve in the aortic root. The blood, in fact, is a concentrated suspension of cells, mainly red blood cells, in a Newtonian matrix, the plasma, and consequently its overall behavior is that of a non-Newtonian fluid owing to the action of the cells' membrane on the fluid part. The common practice, however, assumes the blood in large vessels as a Newtonian fluid since the shear rate is generally high and the effective viscosity becomes independent of the former. In this paper, we show that this is not always the case even in the aorta, the largest artery of the systemic circulation, owing to the pulsatile and transitional nature of the flow. Unexpectedly, for most of the pulsating cycle and in a large part of the fluid volume, the shear rate is smaller than the threshold level for the blood to display a constant effective viscosity and its shear thinning character might affect the system dynamics. A direct inspection of the various flow features has shown that the valve dynamics, the transvalvular pressure drop and the large-scale features of the flow are very similar for the Newtonian and non-Newtonian fluid models. On the other hand, the mechanical damage of the red blood cells (hemolysis), induced by the altered stress values in the flow, is larger for the non-Newtonian fluid model than for the Newtonian one.

  9. Quantitative Mitochondrial Proteomics Study on Protective Mechanism of Grape Seed Proanthocyanidin Extracts Against Ischemia/Reperfusion Heart Injury in Rat

    Institute of Scientific and Technical Information of China (English)

    LU Wei-da; QIU Jie; ZHAO Gai-xia; QIE Liang-yi; WEI Xin-bing; GAO Hai-qing

    2012-01-01

    Cardiac ischemia/reperfusion(I/R) injury is a critical condition,often associated with high morbidity and mortality.The cardioprotective effect of grape seed proanthocyanidin extracts(GSPE) against oxidant injury during I/R has been described in previous studies.However,the underlying molecular mechanisms have not been fully elucidated.This study investigated the effect of GSPE on reperfusion arrhythmias especially ventricular tachycardia(VT)and ventricular fibrillation(VF),the lactic acid accumulation and the ultrastructure of ischemic cardiomyocytes as well as the global changes of mitochondria proteins in in vivo rat heart model against I/R injury.GSPE significantly reduced the incidence of VF and VT,lessened the lactic acid accumulation and attenuated the ultrastructure damage.Twenty differential proteins related to cardiac protection were revealed by isobaric tag for relative and absolute quantitation(iTRAQ) profiling.These proteins were mainly involved in energy metabolism.Besides,monoamine oxidase A(MAOA) was also identified.The differential expression of several proteins was validated by Western blot.Our study offered important information on the mechanism of GSPE treatment in ischemic heart disease.

  10. Marine omega-3 highly unsaturated fatty acids: From mechanisms to clinical implications in heart failure and arrhythmias.

    Science.gov (United States)

    Glück, Tobias; Alter, Peter

    2016-07-01

    Therapeutic implications of marine omega-3 highly unsaturated fatty acids (HUFA) in cardiovascular disease are still discussed controversially. Several clinical trials report divergent findings and thus leave ambiguity on the meaning of oral omega-3 therapy. Potential prognostic indications of HUFA treatment have been predominantly studied in coronary artery disease, sudden cardiac death, ventricular arrhythmias, atrial fibrillation and heart failure of various origin. It is suspected that increased ventricular wall stress is crucially involved in the prognosis of heart failure. Increased wall stress and an unfavorable myocardial remodeling is associated with an increased risk of arrhythmias by stretch-activated membrane ion channels. Integration of HUFA into the microenvironment of cardiomyocyte ion channels lead to allosteric changes and increase the electrical stability. Increased ventricular wall stress appears to be involved in the local myocardial as well as in the hepatic fatty acid metabolism, i.e. a cardio-hepatic syndrome. Influences of an altered endogenous HUFA metabolism and an inverse shift of the fatty acid profile was underrated in the past. A better understanding of these interacting endogenous mechanisms appears to be required for interpreting the findings of recent experimental and clinical studies. The present article critically reviews major studies on basic pathophysiological mechanisms and treatment effects in clinical trials. PMID:27080538

  11. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  12. Overview of Heart Tumors

    Science.gov (United States)

    ... flow, and has grown into the surrounding tissue, heart transplantation may be required. Transplantation is very rarely done ... and only noncancerous tumors are typically considered for heart transplantation. Mechanical cardiac support might be considered until doctors ...

  13. Mendelian-inherited heart disease: a gateway to understanding mechanisms in heart disease Update on work done at the University of Stellenbosch

    OpenAIRE

    Brink, PA; Moolman-Smook, JC; Corfield, VA

    2009-01-01

    Summary Summary The presence of founder effects in South Africa for many single-gene diseases, which include heart diseases such as progressive familial heart block types I and II, hypertrophic cardiomyopathy and the long QT syndromes, afforded us the opportunity to identify causal genes and associated mutations through genetic mapping and positional cloning. From finding the genes, the emphasis has shifted to elucidating how primary defects cause disease and recognising factors that could ex...

  14. INFLUENCE OF MIMIC CARDIAC RATE ON HYDRODYNAMICS OF DIFFERENT MECHANICAL PROSTHETIC CARDIAC VALVES IN VITRO

    Institute of Scientific and Technical Information of China (English)

    Yin-ping Chu; Jin-lian Cheng; Ru-kun Chen; Yu-bo Fan; Fang Pu

    2005-01-01

    Objective To assess the influence of mimic cardiac rate on hydrodynamics of different mechanical prosthetic cardiac valves.Methods US-made CarboMedics bileaflet valve, China-made Jiuling bileaflet valve and C-L tilting disc valve were tested via a pulsatile flow simulator in the aortic position. Testing conditions were set at mimic cardiac rates of 55 bpm, 75 bpm, 100bpm with a constant mimic cardiac output of 4 L/min. The mean pressure differences (△P), leakage volumes (LEV) and closing volumes (CLV) across each valve, and effective orifice areas (EOA) were analyzed.Results Within physiological range, △p, LEV, and CLV decreased as mimic cardiac rate increased, with a large extent of variance. EOA increased along with an increase in mimic cardiac rate. It was a different response in terms of cardiac rate alteration for different types of mechanical prosthetic cardiac valves.Conclusion Mimic cardiac rate change affects hydrodynamics of mechanical prosthetic cardiac valves. Within physiological range, the hydrodynamic of prosthetic bileaflet valve is better than that of tilting disc valve.

  15. The increasing importance of percutaneous mechanical circulatory assist device therapy in heart failure management

    Directory of Open Access Journals (Sweden)

    Ricardo A Weis

    2015-01-01

    Full Text Available Introduction: Advances in medical and surgical care have made it possible for an increasing number of patients with Congenital Heart disease (CHD to live into adulthood. Transposition of the great vessels (TGV is the most common cyanotic congenital cardiac disease where the right ventricle serves as systemic ventricle. It is not uncommon for these patients to have systemic ventricular failure requiring transplantation. Study Design: Hemodynamic decompensation in these patients can be swift and difficult to manage. Increasingly percutaneous LVAD′s such as the Impella (Abiomed, Mass, USA are gaining popularity in these situations owing to their relative ease of placement, both in and outside of the operating room. Conclusion: In this paper we demonstrate that Impella (IMP CP placement through the axillary artery approach shows to be suitable option for short term cardiac support and improvement of end organ perfusion in anticipation of cardiac transplantation.

  16. Hemodynamics of Acute Right Heart Failure in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    McLean, Barbara

    2015-12-01

    In critically ill patients with circulatory shock, the role of the left ventricle has long been appreciated and the object of measurement and therapeutic targeting. The right ventricle is often under appreciated and dysfunction may be overlooked. Generally, the right ventricle operates passively to support the ejection of the left ventricular diastolic volume. A loss of right ventricular wall compliance secondary to pulmonary pressures may result in an alteration in the normal pressure-volume relationship, ultimately affecting the stroke volume and cardiac output. Traditional right heart filling indices may increase because of decreasing compliance, further complicating the picture. The pathophysiology of pulmonary vascular dysfunction in acute respiratory distress syndrome combined with the effects of a mean airway pressure strategy may create an acute cor pulmonale. PMID:26567491

  17. Heart rate variability at limiting stationarity: evidence of neuro-cardiac control mechanisms operating at ultra-low frequencies

    International Nuclear Information System (INIS)

    This study considers the linkage of exogenously stimulated emotional stress with the neurogenic regulation of heart rate operating at very low frequencies. The objectives were three-fold: to consider the present evidence that such a linkage exists as a primary phenomenon; to compare the potential of a frequency-domain method and a time-domain method in revealing this phenomenon by characterizing heart rate variability (HRV) at frequencies of [0.0005…0.4] Hz and to design, implement and report a physiological experiment in which alternating periods of exposure to bland and high valence visual stimuli might reveal this phenomenon. A methodical challenge was to optimize the length of exposure to the stimulus such that subjects did not have time to habituate to stimuli, whilst acquiring sufficient data (heart beats) such that the ultra-low frequency (ULF) components of HRV could be described. With exposure times set to approximately 5 min, during which time the strength of the stimulus and the corresponding evoked response were considered stationary, the lowest HRV frequency component that could be characterized was 0.003 Hz. In trials with parametrically defined test data, the time-domain method based on the Ornstein–Uhlenbeck Gaussian process (OU-GP) was shown to be better than the frequency-domain method in describing the ULF components of the HRV. In an experimental cohort of 16 subjects, analysis using the OU-GP revealed evidence of cardiac regulatory mechanisms influenced by emotional valence operating in the bandwidth (ULF*) [0.002…0.01] Hz. (paper)

  18. Effects of simulated microgravity on circadian rhythm of caudal arterial pressure and heart rate in rats and their underlying mechanism

    Directory of Open Access Journals (Sweden)

    Li CHEN

    2016-04-01

    Full Text Available Objective  To explore the effects of simulated microgravity on the circadian rhythm of rats' caudal arterial pressure and heart rate, and their underlying mechanism. Methods  Eighteen male SD rats (aged 8 weeks were randomly assigned to control (CON and tail suspension (SUS group (9 each. Rats with tail suspension for 28 days were adopted as the animal model to simulate microgravity. Caudal arterial pressure and heart rate of rats were measured every 3 hours. The circadian difference of abdominal aorta contraction was measured by aortic ring test. Western blotting was performed to determine and compare the protein expression level of clock genes such as Per2 (Period2, Bmal1 (Aryl hydrocarbon receptor nuclear translocatorlike and dbp (D element binding protein in suprachiasmatic nucleus (SCN and abdominal aorta of rats in CON and SUS group at different time points. Results  Compared with CON group, the caudal arterial pressure, both systolic and diastolic pressure, decreased significantly and the diurnal variability disappeared, meanwhile the heart rate increased obviously and also the diurnal variability disappeared in rats of SUS group. Compared with CON group, the contraction reactivity of abdominal aorta decreased with disappearence of the diurnal variability, and also the clock genes expression in SCN and abdominal aorta showed no diurnal variability in rats of SUS group. Conclusion  Simulated microgravity may lead to circadian rhythm disorders in rats' cardiovascular system, which may be associated with the changes of the clock genes expression. DOI: 10.11855/j.issn.0577-7402.2016.04.06

  19. Mechanism(s involved in carbon monoxide-releasing molecule-2-mediated cardioprotection during ischaemia-reperfusion injury in isolated rat heart

    Directory of Open Access Journals (Sweden)

    H M Soni

    2012-01-01

    Full Text Available The purpose of the present study was to determine the mechanism(s involved in carbon monoxide-releasing molecule-2, carbon monoxide-releasing molecule-2-induced cardioprotection. We used the transition metal carbonyl compound carbon monoxide-releasing molecule-2 that can act as carbon monoxide donor in cardiac ischaemia-reperfusion injury model using isolated rat heart preparation. Langendorff′s perfused rat hearts when treated with carbon monoxide-releasing molecule-2 (50 μM for 10 min before global ischaemia exhibited significant reduction in postischaemic levels of myocardial injury markers, creatine kinase and lactate dehydrogenase in coronary effluent. Similarly, pretreatment with carbon monoxide-releasing molecule-2 showed significantly improved postischaemic recovery of heart rate, coronary flow rate, cardiodynamic parameters and reduced infarct size as compared to vehicle control hearts. Perfusion with p38 mitogen-activated protein kinase inhibitor, SB203580, a specific inhibitor of α and β isoform, before and concomitantly with carbon monoxide-releasing molecule-2 treatment abolished carbon monoxide-releasing molecule-2-induced cardioprotection. However, p38 mitogen-activated protein kinase alpha inhibitor, SCIO-469, was unable to inhibit the cardioprotective effect of carbon monoxide-releasing molecule-2. Furthermore, protective effect of carbon monoxide-releasing molecule-2 was significantly inhibited by the protein kinase C inhibitor, chelerythrine, when added before and concomitantly with carbon monoxide-releasing molecule-2. It was also observed that, perfusion with phosphatidylinositol 3-kinase inhibitor, wortmannin, before and concomitantly with carbon monoxide-releasing molecule-2 was not able to inhibit carbon monoxide-releasing molecule-2-induced cardioprotection. Interestingly, we observed that wortmannin perfusion before ischaemia and continued till reperfusion significantly inhibited carbon monoxide-releasing molecule

  20. Using heart-lung interactions to assess fluid responsiveness during mechanical ventilation

    OpenAIRE

    Michard, Frédéric; Teboul, Jean-Louis

    2000-01-01

    According to the Frank-Starling relationship, a patient is a 'responder' to volume expansion only if both ventricles are preload dependent. Mechanical ventilation induces cyclic changes in left ventricular (LV) stroke volume, which are mainly related to the expiratory decrease in LV preload due to the inspiratory decrease in right ventricular (RV) filling and ejection. In the present review, we detail the mechanisms by which mechanical ventilation should result in greater cyclic changes in LV...

  1. Cardioprotective mechanisms of Prunus cerasus (sour cherry) seed extract against ischemia-reperfusion-induced damage in isolated rat hearts.

    Science.gov (United States)

    Bak, Istvan; Lekli, Istvan; Juhasz, Bela; Nagy, Norbert; Varga, Edit; Varadi, Judit; Gesztelyi, Rudolf; Szabo, Gergo; Szendrei, Levente; Bacskay, Ildiko; Vecsernyes, Miklos; Antal, Miklos; Fesus, Laszlo; Boucher, Francois; de Leiris, Joel; Tosaki, Arpad

    2006-09-01

    The effects of kernel extract obtained from sour cherry (Prunus cerasus) seed on the postischemic cardiac recovery were studied in isolated working rat hearts. Rats were treated with various daily doses of the extract for 14 days, and hearts were then isolated and subjected to 30 min of global ischemia followed by 120 min of reperfusion. The incidence of ventricular fibrillation (VF) and tachycardia (VT) fell from their control values of 92% and 100% to 50% (not significant) and 58% (not significant), 17% (P<0.05), and 25% (P<0.05) with the doses of 10 mg/kg and 30 mg/kg of the extract, respectively. Lower concentrations of the extract (1 and 5 mg/kg) failed to significantly reduce the incidence of VF and VT during reperfusion. Sour cherry seed kernel extract (10 and 30 mg/kg) significantly improved the postischemic recovery of cardiac function (coronary flow, aortic flow, and left ventricular developed pressure) during reperfusion. We have also demonstrated that the extract-induced protection in cardiac function significantly reflected in a reduction of infarct size. Immunohistochemistry indicates that a reduction in caspase-3 activity and apoptotic cells by the extract, beside other potential action mechanisms of proanthocyanidin, trans-resveratrol, and flavonoid components of the extract, could be responsible for the cardioprotection in ischemic-reperfused myocardium. PMID:16617126

  2. Heart Disease

    Science.gov (United States)

    ... Got Homework? Here's Help White House Lunch Recipes Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  3. Heart murmurs

    Science.gov (United States)

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  4. Mitochondrial damage: An important mechanism of ambient PM{sub 2.5} exposure-induced acute heart injury in rats

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ruijin; Kou, Xiaojing; Geng, Hong; Xie, Jingfang; Tian, Jingjing [Institute of Environmental Science, College of Environmental & Resource Sciences, Shanxi University, Taiyuan (China); Cai, Zongwei, E-mail: zwcai@hkbu.edu.hk [State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR (China); Dong, Chuan, E-mail: dc@sxu.edu.cn [Institute of Environmental Science, College of Environmental & Resource Sciences, Shanxi University, Taiyuan (China)

    2015-04-28

    Highlights: • PM{sub 2.5} induces heart mitochondrial morphological damage of rats. • Mitochondrial fission/fusion gene expression is important regulation mechanism. • Proinflammatoy cytokine level changes are accompanied with mitochondrial damage. • Alterations in oxidative stress and calcium homeostasis are focused on. - Abstract: Epidemiological studies suggested that ambient fine particulate matter (PM{sub 2.5}) exposure was associated with cardiovascular disease. However, the underlying mechanism, especially the mitochondrial damage mechanism, of PM{sub 2.5}-induced heart acute injury is still unclear. In this study, the alterations of mitochondrial morphology and mitochondrial fission/fusion gene expression, oxidative stress, calcium homeostasis and inflammation in hearts of rats exposed to PM{sub 2.5} with different dosages (0.375, 1.5, 6.0 and 24.0 mg/kg body weight) were investigated. The results indicated that the PM{sub 2.5} exposure induced pathological changes and ultra-structural damage in hearts such as mitochondrial swell and cristae disorder. Furthermore, PM{sub 2.5} exposure significantly increased specific mitochondrial fission/fusion gene (Fis1, Mfn1, Mfn2, Drp1 and OPA1) expression in rat hearts. These changes were accompanied by decreases of activities of superoxide dismutase (SOD), Na{sup +}K{sup +}-ATPase and Ca{sup 2+}-ATPase and increases of levels of malondialdehyde (MDA), inducible nitric oxide synthase (iNOS) and nitric oxide (NO) as well as levels of pro-inflammatory mediators including TNF-α, IL-6 and IL-1β in rat hearts. The results implicate that mitochondrial damage, oxidative stress, cellular homeostasis imbalance and inflammation are potentially important mechanisms for the PM{sub 2.5}-induced heart injury, and may have relations with cardiovascular disease.

  5. Pyruvate dehydrogenase kinase regulatory mechanisms and inhibition in treating diabetes, heart ischemia, and cancer.

    Science.gov (United States)

    Roche, T E; Hiromasa, Y

    2007-04-01

    The fraction of pyruvate dehydrogenase complex (PDC) in the active form is reduced by the activities of dedicated PD kinase isozymes (PDK1, PDK2, PDK3 and PDK4). Via binding to the inner lipoyl domain (L2) of the dihydrolipoyl acetyltransferase (E2 60mer), PDK rapidly access their E2-bound PD substrate. The E2-enhanced activity of the widely distributed PDK2 is limited by dissociation of ADP from its C-terminal catalytic domain, and this is further slowed by pyruvate binding to the N-terminal regulatory (R) domain. Via the reverse of the PDC reaction, NADH and acetyl-CoA reductively acetylate lipoyl group of L2, which binds to the R domain and stimulates PDK2 activity by speeding up ADP dissociation. Activation of PDC by synthetic PDK inhibitors binding at the pyruvate or lipoyl binding sites decreased damage during heart ischemia and lowered blood glucose in insulin-resistant animals. PDC activation also triggers apoptosis in cancer cells that selectively convert glucose to lactate. PMID:17310282

  6. Biomedical engineering support. Annual progress report, August 15, 1974--August 14, 1975. [/sup 238/PuO/sub 2/-powered mechanical heart

    Energy Technology Data Exchange (ETDEWEB)

    Kolff, W.J.; Smith, L.M.; Sandquist, G.M.

    1975-01-01

    The major responsibility of the Institute for Biomedical Engineering at the University of Utah under the ERDA Artificial Heart Program has been to provide in vitro and in vivo experimental data and evaluation of the anatomical fitting, accommodation, performance and adequacy of the artificial heart system and its components as they are developed in the ERDA Program and provided to the Institute for study. The Institute also has the responsibility of designing, constructing and testing the blood handling components of the Blood Pump and insuring reliability, durability and satisfactory performance of these system components. During the reporting period, nine total heart replacement experiments were performed in calves using the ERDA Blood Pump powered by an electric motor implanted in the abdomen. Results of the experiments are given. Ultimately the mechanical heart will be powered by a radioisotope heat source. (TFD)

  7. [Clinical experience of mechanical ventricular support with centrifugal pump for severe ventricular failure after open heart surgery].

    Science.gov (United States)

    Matsuwaka, R; Matsuda, H; Kaneko, M; Masai, T; Fudemoto, Y; Kobayashi, T; Imagawa, H; Miyamoto, K; Morisaki, H; Kawashima, Y

    1990-09-01

    Five adult patients (pts) with age 15-67 (mean 43) received mechanical circulatory support with centrifugal pump (Biomedicus, BP-80, Sarns centrifugal pump) for postcardiotomy profound shock. Three pts underwent left ventricular support (LVS) alone, and the other 2 required biventricular support (BVS). Duration of the LVS ranged from 33 to 240 hours (mean 126 hours) and the right ventricular support 92, 120 hrs. Pump flow rate was 1.1 to 2.5 (mean 1.9) L/min/m2. Sixteen pumps were used and the pump exchange was performed 9 times in five pts and an average perfusion time per pump was 57 hrs. Two of 3 pts with LVS alone survived and one died of multiorgan failure associated with right heart dysfunction. In two pts with BVS, one survived and the other died of persistent low cardiac output early after pump removal. As the complication during mechanical support, bleeding was seen in 3 pts and cerebral infarction in one. Although centrifugal pump has potential limitation in antithrombogenicity and durability, this device provides a simple and effective mechanical circulatory support.

  8. In Vitro Study of Influence of Mimic Cardiac Rate on Hydrodynamics of the Different Mechanical Cardiac Valve Prostheses

    Institute of Scientific and Technical Information of China (English)

    CHU Yin-ping; CHENG Jin-lian; CHEN Ru-kun; FAN Yu-bo; PU Fang

    2005-01-01

    Objective:To assess the influence of mimic cardiac rate on hydrodynamics of the different mechanical prosthetic cardiac valves. Methods: US-made CarboMedics bileaflet valve and China-made Jiuling bileaflet valve and C-L tilting disc valve have been tested in a pulsatile flow simulator in the aortic position. The testing condition was set at the mimic cardiac rate of 55 beats/min,75 beats/min,100beats/min and a constant mimic cardiac output of 4L/min. The mean pressure differences (△P) ,leakage volumes (LEV) and closing volumes (CLV) across each valve,and the effective orifice areas(EOA) have been analyzed. Results:Within the range of physiology,the △P,LEV and CLV were falling as the increasing of mimic cardiac rate,and the extent of variance was larger. The EOA was increasing with the increase of the mimic cardiac rate. It is a different response as the altering of the cardiac rate for the different type of the mechanical prosthetic cardiac valves.Conclusions:The change of the mimic cardiac rate can affect the hydrodynamics of the mechanical prosthetic cardiac valves. The hydrodynamics of the bileaflet valve prosthesis is better than the tilting disc valve.

  9. Central autonomic control of the heart, angina, and pathogenic mechanisms of post-myocardial infarction depression

    NARCIS (Netherlands)

    Ter Horst, GJ

    1999-01-01

    Depression can develop in 20% of the patients with a myocardial infarction (MI). Pathobiological mechanisms underlying the development of mood disorders in these patients are unknown. Since post-MI depression has been associated with increased risk of mortality we hypothesized that dysfunction of li

  10. Anticoagulation in pregnant women with mechanical heart valves : the new ESC guidelines

    NARCIS (Netherlands)

    Pieper, P. G.

    2012-01-01

    In pregnant women with a mechanical valve prosthesis, anticoagulation therapy is challenging because of the risk of embryopathy with vitamin K antagonists (VKA's), while unfractioned heparin and low molecular weight heparin (LMWH) are associated with a higher risk of valve thrombosis [1]. The presen

  11. Why increased nuchal translucency is associated with congenital heart disease: a systematic review on genetic mechanisms

    NARCIS (Netherlands)

    Burger, N.B.; Bekker, M.N.; Groot, C.J. de; Christoffels, V.M.; Haak, M.C.

    2015-01-01

    This overview provides insight into the underlying genetic mechanism of the high incidence of cardiac defects in fetuses with increased nuchal translucency (NT). Nuchal edema, the morphological equivalent of increased NT, is likely to result from abnormal lymphatic development and is strongly relate

  12. Protective effect of acupuncture on heart in mice with hyperlipemia and its mechanism

    Institute of Scientific and Technical Information of China (English)

    申洪波

    2014-01-01

    Objective To observe the inhibiting effect of acupuncture on blood lipid,myocardial hypertrophy and fibrosis in mice with hyperlipemia,and explore its possible action mechanism.Methods Ten inbred mice(C57)were applied.Forty ApoE(-/-)mice removed gene of apolipoprotein E were randomly divided into a control

  13. Lungs in Heart Failure

    OpenAIRE

    Anna Apostolo; Giuliano Giusti; Paola Gargiulo; Maurizio Bussotti; Piergiuseppe Agostoni

    2012-01-01

    Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance...

  14. Heart valve surgery

    Science.gov (United States)

    Valve replacement; Valve repair; Heart valve prosthesis; Mechanical valves, Prosthetic valves ... made materials, such as metal (stainless steel or titanium) or ceramic. These valves last the longest, but ...

  15. Nanosecond pulse electric field activation of platelet-rich plasma reduces myocardial infarct size and improves left ventricular mechanical function in the rabbit heart.

    Science.gov (United States)

    Hargrave, Barbara; Li, Francis

    2012-12-01

    In the current study, we used the novel, nonchemical method of nanosecond pulsed electric fields (nsPEF) to investigate the efficiency of a protocol involving the in vivo treatment of the ischemic and reperfused heart and heart cells in culture with platelet-rich plasma (PRP). Associated with the restoration of blood flow to the ischemic tissue is a phenomenon referred to as "ischemic reperfusion injury." Clinically a type of reperfusion injury occurs during coronary bypass surgery once blood perfusion to the heart is restarted. Although the restoration of oxygen to ischemic myocardial cells is critical for tissue survival, reperfusion causes myocardial oxidative stress, attributable in part to the increased production of reactive oxygen species (ROS). Enhanced ROS production is associated with mitochondrial damage. Adult female New Zealand white rabbits were anesthetized and a left thoracotomy performed to expose the heart. The distal segment of the left anterior descending coronary artery was occluded for 15 minutes and then released so reperfusion of the tissue could occur. PRP (.21 mg/heart) or saline was injected into the ischemic area of the myocardium. Mechanical function of the left ventricle was analyzed using a Millar catheter attached to a Micro-Med Analysis System. H9c2 cells in culture were treated with 1 mL of nsPEF activated PRP (1.05 mg/flask) for 24 hours before analysis for ROS production or mitochondrial depolarization damage). The left ventricle contracted and relaxed faster and infarct size was reduced in hearts treated with PRP compared with saline. ROS production and mitochondrial depolarization were reduced in H9c2 cells treated with PRP and stimulated with hydrogen peroxide. These results provide evidence that nsPEFs can successfully be used to prepare PRP and that the PRP is functional in heart protection possibly by reducing ROS generation and stabilizing the mitochondria of the ischemic/reperfused heart.

  16. Characterization of three-dimensional anisotropic heart valve tissue mechanical properties using inverse finite element analysis.

    Science.gov (United States)

    Abbasi, Mostafa; Barakat, Mohammed S; Vahidkhah, Koohyar; Azadani, Ali N

    2016-09-01

    Computational modeling has an important role in design and assessment of medical devices. In computational simulations, considering accurate constitutive models is of the utmost importance to capture mechanical response of soft tissue and biomedical materials under physiological loading conditions. Lack of comprehensive three-dimensional constitutive models for soft tissue limits the effectiveness of computational modeling in research and development of medical devices. The aim of this study was to use inverse finite element (FE) analysis to determine three-dimensional mechanical properties of bovine pericardial leaflets of a surgical bioprosthesis under dynamic loading condition. Using inverse parameter estimation, 3D anisotropic Fung model parameters were estimated for the leaflets. The FE simulations were validated using experimental in-vitro measurements, and the impact of different constitutive material models was investigated on leaflet stress distribution. The results of this study showed that the anisotropic Fung model accurately simulated the leaflet deformation and coaptation during valve opening and closing. During systole, the peak stress reached to 3.17MPa at the leaflet boundary while during diastole high stress regions were primarily observed in the commissures with the peak stress of 1.17MPa. In addition, the Rayleigh damping coefficient that was introduced to FE simulations to simulate viscous damping effects of surrounding fluid was determined. PMID:27173827

  17. Time-dependent biaxial mechanical behavior of the aortic heart valve leaflet.

    Science.gov (United States)

    Stella, John A; Liao, Jun; Sacks, Michael S

    2007-01-01

    . The relation between collagen fibril kinematics and mechanical properties in the mitral valve anterior leaflet. Journal of Biomechanical Engineering 129 (1), 78-87], we speculate that the mechanisms underlying this quasi-elastic behavior may be attributed to inter-fibrillar structures unique to valvular tissues. These mechanisms are an important functional aspect of native valvular tissues, and are likely critical to improve our understanding of valvular disease and help guide the development of valvular tissue engineering and surgical repair.

  18. Heart Transplant

    Science.gov (United States)

    ... 2015 A heart transplant gives a patient with congenital heart disease the opportunity to have a normal heart with ... pulmonary artery and left atrium. In patients with congenital heart disease, the surgeon may simultaneous transplant the lungs and ...

  19. Heart Block

    Science.gov (United States)

    ... the signal causes the heart to contract and pump blood. Heart block occurs if the electrical signal is ... degree heart block limits the heart's ability to pump blood to the rest of the body. This type ...

  20. Why increased nuchal translucency is associated with congenital heart disease: a systematic review on genetic mechanisms.

    Science.gov (United States)

    Burger, Nicole B; Bekker, Mireille N; de Groot, Christianne J M; Christoffels, Vincent M; Haak, Monique C

    2015-06-01

    This overview provides insight into the underlying genetic mechanism of the high incidence of cardiac defects in fetuses with increased nuchal translucency (NT). Nuchal edema, the morphological equivalent of increased NT, is likely to result from abnormal lymphatic development and is strongly related to cardiac defects. The underlying genetic pathways are, however, unknown. This study aims to present a systematic overview of genes involved in both cardiac and lymphatic development in mouse embryos. A search of PubMed and the Mammalian Phenotype Browser was performed. Fifteen candidate genes involved in both cardiac and lymphatic development were identified: Adrenomedullin; Chicken ovalbumin upstream promoter-transcription factor 2 (COUP-TFII); Cyp51; Ephrin-B2; Forkhead box protein C2 (Foxc2); Nuclear factor of activated T cells, cytoplasmic 1 (Nfatc1); Neurofibromatosis type 1 (Nf1); Phosphoinositide 3-kinase encoding isoform p110α (Pik3ca); Podoplanin; Prospero-related homeobox 1 (Prox1); T-box 1 (Tbx1); Tyrosine kinase with immunoglobulin-like and endothelial growth factor-like domains 1 (Tie1); vascular endothelial growth factor (Vegf)-A; Vegf receptor-3 (Vegfr-3); and Vascular endothelial zinc finger 1 (Vezf1). Mutations in all but one gene (Pik3ca) resulted in both a cardiac defect and nuchal edema. Candidate genes - mainly encoding for endothelium - are involved in both cardiac and lymphatic development. Alterations in candidate genes are associated with the strong relation between increased NT and cardiac defects. PMID:25728762

  1. Low standard oral anticoagulation therapy for Chinese patients with St.Jude mechanical heart valves

    Institute of Scientific and Technical Information of China (English)

    孙晓刚; 胡盛寿; 祁国奇; 周玉燕

    2003-01-01

    Objective To study the efficacy of the low standard oral anticoagulation therapy following St Jude Medical (SJM) valve implantation for Chinese patients.Methods Totally 805 patients with a mean age of 42.70±11.09 years, enrolled into this study. Among them, 230 underwent aortic valve replacements (AVR), 381 mitral valve replacements (MVR), 189 double valve replacements (DVR) and 5 tricuspid valve replacememts (TVR). All patients received postoperative oral anticoagulation therapy based on a low standard of international normalized ratio (INR, 2.0-2.5). Of the 805 patients, 710 were followed up for 0.25-13 years (a median, 4.15 years). Results Postoperatively, 17 adverse events occurred. Operative mortality was 2.11%. The most frequent cause of operative mortality was a low cardiac output. During follow-up, there were 47 anticoagulant-induced hemorrhages [1.59%/patient-year (pt-yr)], 10 cases of thromboembolism (0.34%/pt-yr), and 3 mechanical valve thromboses (0.19%/pt-yr). There were 44 late deaths and the linearized late mortality rates were 0.51%pt-yr. Estimates of actuarial survival for all patients at 5 and 10 years was 97.45% (0.70%) and 77.96% (17.44%), respectively.Conclusions A low target INR range of 2.0-2.5 is preferable for Chinese patients so as to reduce the severe bleeding complications in those with conventionally higher levels of INR. The long-term results were satisfactory in terms of the numbers of those who suffered thrombosis, embolism and bleeding.

  2. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure.

    Science.gov (United States)

    Madamanchi, Chaitanya; Alhosaini, Hassan; Sumida, Arihiro; Runge, Marschall S

    2014-10-20

    Many advances have been made in the diagnosis and management of heart failure (HF) in recent years. Cardiac biomarkers are an essential tool for clinicians: point of care B-type natriuretic peptide (BNP) and its N-terminal counterpart (NT-proBNP) levels help distinguish cardiac from non-cardiac causes of dyspnea and are also useful in the prognosis and monitoring of the efficacy of therapy. One of the major limitations of HF biomarkers is in obese patients where the relationship between BNP and NT-proBNP levels and myocardial stiffness is complex. Recent data suggest an inverse relationship between BNP and NT-proBNP levels and body mass index. Given the ever-increasing prevalence of obesity world-wide, it is important to understand the benefits and limitations of HF biomarkers in this population. This review will explore the biology, physiology, and pathophysiology of these peptides and the cardiac endocrine paradox in HF. We also examine the clinical evidence, mechanisms, and plausible biological explanations for the discord between BNP levels and HF in obese patients.

  3. Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations.

    Science.gov (United States)

    Low Wang, Cecilia C; Hess, Connie N; Hiatt, William R; Goldfine, Allison B

    2016-06-14

    Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting.

  4. Device Thrombogenicty Emulator (DTE) – Design optimization Methodology for Cardiovascular Devices: A Study in Two Bileaflet MHV Designs

    OpenAIRE

    Xenos, Michalis; Girdhar, Gaurav; Alemu, Yared; Jesty, Jolyon; Slepian, Marvin; Einav, Shmuel; Bluestein, Danny

    2010-01-01

    Patients who receive prosthetic heart valve (PHV) implants require mandatory anticoagulation medication after implantation due to the thrombogenic potential of the valve. Optimization of PHV designs may facilitate reduction of flow-induced thrombogenicity and reduce or eliminate the need for post-implant anticoagulants. We present a methodology entitled Device Thrombogenicty Emulator (DTE) for optimizing the thrombo-resistance performance of PHV by combining numerical and experimental approac...

  5. Short-term mechanical circulatory support by veno-arterial extracorporeal membrane oxygenation in the management of cardiogenic shock and end-stage heart failure.

    Science.gov (United States)

    Brugts, Jasper J; Caliskan, Kadir

    2014-02-01

    Despite modern treatment modalities, cardiogenic shock is associated with a very high risk of mortality and morbidity. The short- and long-term survival in patients with cardiogenic shock or end-stage heart failure has improved considerably by recent technological advances in short and long-term mechanical circulatory support devices. For short-term mechanical support, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used as bridge-to-decision and bridge-to-recovery in cardiogenic shock patients. Long-term mechanical circulatory support devices such as left ventricular assist devices (LVADs) are widely available and play a central role in bridge-to-transplantation in those eligible for heart transplantation (HTX) and as destination therapy (DT) in those not eligible for heart transplantation. Nevertheless, patients with critical cardiogenic shock show a deleterious outcome after LVAD-implantation or HTX with higher mortality, more complications and higher burden on financial resources. These considerations underscore the importance of optimal timing and appropriate patient selection for eventual LVAD therapy. The current report will focus on the immediate management of patients with cardiogenic shock with inotropes, discuss the use of IABP and focus mainly on pivotal choices to be made in the period spanned by short term mechanical circulatory support in patients with refractory cardiogenic shock.

  6. Strategies and outcomes of periprocedural bridging therapy with low-molecular-weight heparin in patients with mechanical heart valves.

    Science.gov (United States)

    Schulman, Jacqueline M; Majeed, Ammar; Mattsson, Eva; Schulman, Sam; Holmström, Margareta; Ågren, Anna

    2015-11-01

    Patients with mechanical heart valves (MHV) undergoing invasive procedures often receive periprocedural bridging with low-molecular-weight heparin (LMWH). The bridging strategies used in real-life and the predictors for bleeding and thrombosis are not well studied. We retrospectively assessed patients with MHV that underwent invasive procedures requiring vitamin K antagonist interruption and LMWH bridging. Thromboembolic and bleeding events occurring up to 30 days after the procedures were recorded. Predictors of major bleeding events (MBEs) were analyzed with logistic regression. We evaluated 547 patients with MHV who underwent 275 procedures during a 6.5-year period. Bridging with LMWH was used in 185 procedures in a total of 117 patients. Combined pre- and post-operative bridging was the most frequently employed (63 %). Doses of LMWH were prophylactic in 96 (52 %) of the procedures and therapeutic in 89 (48 %). The procedure-related bleeding risk was evaluated as high in 70 (38 %) and low in 115 (62 %) of the procedures. There was a trend to more frequent use of prophylactic doses (61 %) in high-risk surgery, and more therapeutic doses (53 %) in low-risk ones. There were 36 bleeding episodes, 21 (11 % of procedures) of which were classified as MBEs, but there were no thromboembolic events. Most MBEs (n = 14; 67 %) occurred in surgeries with high bleeding risk. In the multivariate analysis, the bleeding risk of the surgery itself was the only independent predictor for MBEs. For patients with MHV receiving perioperative bridging with LMWH, the major predictor for MBE is the bleeding risk of the surgery.

  7. Perioperative Anticoagulation in Patients with Mechanical Heart Valves Undergoing Elective Surgery: Results of a Survey Conducted among Korean Physicians

    Science.gov (United States)

    Kim, Sehyun; Lim, Chang Young; Lee, Jong Seok; Park, Seonyang; Garcia, David; Crowther, Mark A.; Ageno, Walter

    2005-01-01

    The optimal perioperative anticoagulation management in patients on warfarin therapy is poorly defined due to the lack of randomized trials. Because guidelines are heterogeneous, it was hypothesized that "treatment strategies are not uniform in clinical practice". Between February 2003 and May 2003, a questionnaire with 4 different clinical scenarios was distributed to physicians by e-mail, or direct contact was made by a survey monitor. Two scenarios described the cases of patients with a mechanical heart valve (MHV) in the mitral position, with additional risk factors for a systemic embolism; one undergoing major (scenario 1) and the other minor surgery (scenario 3). Two scenarios described patients with an aortic MHV; one undergoing major (scenario 2) and the other minor (scenario 4) surgery. Different preoperative and postoperative management options were offered. The treatment options for all scenarios were the same. Of the 90 questionnaires distributed, 52 (57.8%) were returned. Hospitalization for full-dose intravenous unfractionated heparin (IV UH) was the most commonly selected strategy in the preoperative phase for scenarios 1 (59%), 2 (42%) and 3 (44%). In scenario 4, 34% chose IV UH. Outpatient, full-dose, subcutaneous UH or low-molecular-weight heparin (LMWH) was the most selected option in the postoperative phase for all scenarios, with the exception of number 4 (52.9% in scenario 1, 34% in scenario 2, 32%, in scenario 3 and 28% in scenario 4). Even among expert clinicians, the management of perioperative anticoagulation is heterogeneous. In particular, the definition of risk categories and the optimal intensity of antithrombotic drugs need to be defined by well-designed prospective studies. PMID:15744807

  8. Strategies and outcomes of periprocedural bridging therapy with low-molecular-weight heparin in patients with mechanical heart valves.

    Science.gov (United States)

    Schulman, Jacqueline M; Majeed, Ammar; Mattsson, Eva; Schulman, Sam; Holmström, Margareta; Ågren, Anna

    2015-11-01

    Patients with mechanical heart valves (MHV) undergoing invasive procedures often receive periprocedural bridging with low-molecular-weight heparin (LMWH). The bridging strategies used in real-life and the predictors for bleeding and thrombosis are not well studied. We retrospectively assessed patients with MHV that underwent invasive procedures requiring vitamin K antagonist interruption and LMWH bridging. Thromboembolic and bleeding events occurring up to 30 days after the procedures were recorded. Predictors of major bleeding events (MBEs) were analyzed with logistic regression. We evaluated 547 patients with MHV who underwent 275 procedures during a 6.5-year period. Bridging with LMWH was used in 185 procedures in a total of 117 patients. Combined pre- and post-operative bridging was the most frequently employed (63 %). Doses of LMWH were prophylactic in 96 (52 %) of the procedures and therapeutic in 89 (48 %). The procedure-related bleeding risk was evaluated as high in 70 (38 %) and low in 115 (62 %) of the procedures. There was a trend to more frequent use of prophylactic doses (61 %) in high-risk surgery, and more therapeutic doses (53 %) in low-risk ones. There were 36 bleeding episodes, 21 (11 % of procedures) of which were classified as MBEs, but there were no thromboembolic events. Most MBEs (n = 14; 67 %) occurred in surgeries with high bleeding risk. In the multivariate analysis, the bleeding risk of the surgery itself was the only independent predictor for MBEs. For patients with MHV receiving perioperative bridging with LMWH, the major predictor for MBE is the bleeding risk of the surgery. PMID:25868460

  9. Prospective ECG triggering reduces prosthetic heart valve-induced artefacts compared with retrospective ECG gating on 256-slice CT

    Energy Technology Data Exchange (ETDEWEB)

    Symersky, Petr [Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); Habets, Jesse; Budde, Ricardo P.J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Westers, Paul [University Medical Center Utrecht, Department of Biostatistics, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Mol, Bas A.J.M. de [Academic Medical Center, Department of Cardiothoracic Surgery, Amsterdam (Netherlands); University of Technology Eindhoven, Department of Biomedical Engineering, Eindhoven (Netherlands); Prokop, Mathias [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands)

    2012-06-15

    Multidetector computed tomography (MDCT) has diagnostic value for the evaluation of prosthetic heart valve (PHV) dysfunction but it is hampered by artefacts. We hypothesised that image acquisition using prospective triggering instead of retrospective gating would reduce artefacts related to pulsating PHV. In a pulsatile in vitro model, a mono- and bileaflet PHV were imaged using 256 MDCT at 60, 75 and 90 beats per minute (BPM) with either retrospective gating (120 kV, 600 mAs, pitch 0.2, CTDI{sub vol} 39.8 mGy) or prospective triggering (120 kV, 200 mAs, CTDI{sub vol} 13.3 mGy). Two thresholds (>175 and <-45HU), derived from the density of surrounding structures, were used for quantification of hyper- and hypodense artefacts. Image noise and artefacts were compared between protocols. Prospective triggering reduced hyperdense artefacts for both valves at every BPM (P = 0.001 all comparisons). Hypodense artefacts were reduced for the monoleaflet valve at 60 (P = 0.009), 75 (P = 0.016) and 90 BPM (P = 0.001), and for the bileaflet valves at 60 (P = 0.001), 90 (P = 0.001) but not at 75 BPM (P = 0.6). Prospective triggering reduced image noise at 60 (P = 0.001) and 75 (P < 0.03) but not at 90 BPM. Compared with retrospective gating, prospective triggering reduced most artefacts related to pulsating PHV in vitro. circle Computed tomographic images are often degraded by prosthetic heart valve-induced artefacts circle Prospective triggering reduces prosthetic heart valve-induced artefacts in vitro circle Artefact reduction at 90 beats per minute occurs without image noise reduction circle Prospective triggering may improve CT image quality of moving hyperdense structures. (orig.)

  10. In vitro heart valve testing: steady versus pulsatile flow.

    Science.gov (United States)

    Black, M M; Hose, D R; Lamb, C J; Lawford, P V; Ralph, S J

    1994-03-01

    The design of artificial heart valves has traditionally been based on the development of a prototype device which was then subjected to extensive laboratory testing in order to confirm its suitability for clinical use. In the past the in vitro assessment of a valve's performance was based principally on the measurement of parameters such as pressure difference, regurgitation and, more recently, energy losses. Such measurements can be defined as being at the 'macro' level and rarely show any clinically significant differences amongst currently available prostheses. The analytical approach to flow through heart valves has previously been hampered by difficulties experienced in solving the relevant equations of flow particularly in the case of pulsatile conditions. Computational techniques are now available which enable appropriate solutions to be obtained for these problems and consequently provide an opportunity for detailed examination of the 'micro' level of flow disturbances exhibited by the different valves. This present preliminary study is designed to illustrate the use of such an analytical approach to the flow through prosthetic valves. A single topic has been selected for this purpose which is the comparative value of steady versus pulsatile flow testing. A bileaflet valve was chosen for the analysis and a mathematical model of this valve in the aortic position of the Sheffield Pulse Duplicator was created. The theoretical analysis was carried out using a commercially available Computational Fluid Dynamics package, namely, FIDAP, on a SUN MICROSYSTEMS 10-30 workstation.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Heart Anatomy

    Science.gov (United States)

    ... Incredible Machine Bonus poster (PDF) The Human Heart Anatomy Blood The Conduction System The Coronary Arteries The ... of the Leg Vasculature of the Torso Heart anatomy illustrations and animations for grades K-6. Heart ...

  12. Ultrasound-targeted transfection of tissue-type plasminogen activator gene carried by albumin nanoparticles to dog myocardium to prevent thrombosis after heart mechanical valve replacement

    Directory of Open Access Journals (Sweden)

    Ji J

    2012-06-01

    Full Text Available Ji Jun, Ji Shang-Yi, Yang Jian-An, He Xia, Yang Xiao-Han, Ling Wen-Ping, Chen Xiao-LingDepartment of Pathology and Cardiovascular Surgery, Shenzhen Sun Yat-Sen Cardiovascular Hospital, Shenzhen, Guangdong, People's Republic of ChinaBackground: There are more than 300,000 prosthetic heart valve replacements each year worldwide. These patients are faced with a higher risk of thromboembolic events after heart valve surgery and long-term or even life-long anticoagulative and antiplatelet therapies are necessary. Some severe complications such as hemorrhaging or rebound thrombosis can occur when the therapy ceases. Tissue-type plasminogen activator (t-PA is a thrombolytic agent. One of the best strategies is gene therapy, which offers a local high expression of t-PA over a prolonged time period to avoid both systemic hemorrhaging and local rebound thrombosis. There are some issues with t-PA that need to be addressed: currently, there is no up-to-date report on how the t-PA gene targets the heart in vivo and the gene vector for t-PA needs to be determined.Aims: To fabricate an albumin nano-t-PA gene ultrasound-targeted agent and investigate its targeting effect on prevention of thrombosis after heart mechanic valve replacement under therapeutic ultrasound.Methods: A dog model of mechanical tricuspid valve replacement was constructed. A highly expressive t-PA gene plasmid was constructed and packaged by nanoparticles prepared with bovine serum albumin. This nanopackaged t-PA gene plasmid was further cross-linked to ultrasonic microbubbles prepared with sucrose and bovine serum albumin to form the ultrasonic-targeted agent for t-PA gene transfection. The agent was given intravenously followed by a therapeutic ultrasound treatment (1 MHz, 1.5 w/cm2, 10 minutes of the heart soon after valve replacement had been performed. The expression of t-PA in myocardium was detected with multiclonal antibodies to t-PA by the indirect immunohistochemical method

  13. Three-component laser Doppler velocimetry measurements in the vicinity of mechanical heart valves in a mock-circulatory loop

    Science.gov (United States)

    Meyer, Richard Scott

    Streakline flow visualization and three-component laser Doppler velocimetry were conducted in a mock-circulatory loop on four mechanical heart valve types in the mitral position. Measurements were conducted in the regurgitant flow region proximal to the valve. Results for the Bjork-Shiley Monostrutsp{TM} valve showed a highly non-uniform flow at valve closure, with very large velocities in the minor orifice region. These velocities were on the order of 15-20 mps and lasted less than one millisecond. Following closure, an interval of sustained regurgitant flow persisted for the duration of systole. Reynolds stresses were calculated from three-dimensional data, and yielded a maximum of 8,100 dyne/cmsp2. Values as high as 80,000 dyne/cmsp2 were calculated during the initial spike, but due to the intermittency of the spike, they are artificially high. Similar measurements were conducted in the minor orifice of the Medtronic-Hall valve, and maximum velocities of about 4 mps were measured during the sustained regurgitant flow. Maximum Reynolds shear stresses were about 7,000 dyne/cmsp2. The velocity spike at closing was noted with this valve also. Two-component measurements around the center hole in the occluder showed a sustained jet with maximum velocities of about 1 mps, and maximum Reynolds shear stresses of about 2,000 dyne/cmsp2. Measurements in the St. Jude Medical valve showed velocities and stresses to be very low. No closing spike was measured, and sustained velocities were observed in the hinge region of about 0.2 mps with maximum stresses of about 1,000 dyne/cmsp2. The CarboMedicssp{TM} valve showed a regurgitant jets emanating from the gap between the leaflet and valve housing ring, with velocities of 3.3 mps for the duration of systole, and calculated stresses of 8,100 dyne/cmsp2. No closing spike was noted. Differences between two and three-dimensional Reynolds shear stresses were significant only at locations where two-dimensional calculated values were

  14. Use of the Frog Heart Preparation to Teach Students about the Spontaneous Mechanical Activity of the Vena Cava

    Science.gov (United States)

    Hill, Brent J. F.; Goodman, Ian; Moran, William M.

    2011-01-01

    Most undergraduate physiology texts describe veins simply as reservoirs for blood and conduits for return of blood to the heart. This article describes a laboratory exercise that can be performed by students to demonstrate that veins are much more than reservoirs and conduits for blood flow: they possess a dynamic rhythmic contraction. In this…

  15. Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

    NARCIS (Netherlands)

    P. Symersky; R.P.J. Budde; P. Westers; B.A.J.M. de Mol; M. Prokop

    2011-01-01

    Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. A Medtronic Hall ti

  16. Multidetector CT imaging of mechanical prosthetic heart valves : quantification of artifacts with a pulsatile in-vitro model

    NARCIS (Netherlands)

    Symersky, Petr; Budde, Ricardo P. J.; Westers, Paul; de Mol, Bas A. J. M.; Prokop, Mathias

    2011-01-01

    Objectives Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. Methods

  17. Multidetector CT imaging of mechanical prosthetic heart valves: quantification of artifacts with a pulsatile in-vitro model

    NARCIS (Netherlands)

    Symersky, P.; Budde, R.P.; Westers, P.; Mol, B.A. de; Prokop, M.

    2011-01-01

    OBJECTIVES: Multidetector computed tomography (MDCT) can detect the cause of prosthetic heart valve (PHV) dysfunction but is hampered by valve-induced artifacts. We quantified artifacts of four PHV using a pulsatile in-vitro model and assessed the relation to leaflet motion and valve design. METHODS

  18. Cytochrome P450 (CYP2C9FNx012,FNx013 & vitamin-K epoxide reductase complex (VKORC1 -1639G < A gene polymorphisms & their effect on acenocoumarol dose in patients with mechanical heart valve replacement

    Directory of Open Access Journals (Sweden)

    Anupriya Kaur

    2013-01-01

    Interpretation & conclusions: The study findings point towards the role of CYP2C9 and VKORC1 gene polymorphisms in determining the inter-individual dose variability of acenocoumarol in the Indian patients with mechanical heart valve replacement.

  19. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  20. Heart Diseases

    Science.gov (United States)

    ... re like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  1. Heart Attack

    Science.gov (United States)

    ... having another heart attack. These medicines include: aspirin, beta blockers, statins, ACE inhibitors and fish oil. Your doctor ... have had a stent placed in your heart. Beta blockers are a group of drugs that lower the ...

  2. Heart Failure

    Science.gov (United States)

    ... blood. In other cases, the heart can't pump blood to the rest of the body with enough ... failure affects the right side, the heart cannot pump enough blood to the lungs, where it picks up oxygen. ...

  3. Heart Disease

    Science.gov (United States)

    ... occurs when the heart is not able to pump blood through the body as well as it should. ... arteries. The pressure is highest when your heart pumps blood into your arteries – when it beats. It is ...

  4. Heart Attack

    Science.gov (United States)

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  5. HEART RETRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    R. Sh. Saitgareev

    2016-01-01

    Full Text Available The number of patients with transplanted heart is continuously increasing; therefore, the number of patients requiring heart retransplantation grows. Analysis of the results of published studies focused on safety of cardiac retransplantation and risk factors for adverse events in perioperative, early and late postoperative periods is presented in our review. The results of published studies suggest that heart retransplantation is the main radical treatment option for cardiac allograft dysfunction, but the results of heart retransplantation are slightly worse than those of primary cardiac transplantation. On the other hand, the favorable long-term prognosis after heart retransplantation should be expected in carefully selected recipients. 

  6. Low radiation dose non-contrast cardiac CT: is it of value in the evaluation of mechanical aortic valve

    Energy Technology Data Exchange (ETDEWEB)

    Bazeed, Mohamed Fayez (Dept. of Diagnostic Radiology, Faculty of Medicine, Mansoura Univ. (Egypt)), email: m_bazeed@yahoo.com; Moselhy, Mohamed Saleh (Cardiology Dept. Faculty of Medicine, Suez Canal Univ. (Egypt)); Rezk, Ahmad Ibrahim (Dept. of Cardiac Surgery, Faculty of Medicine, Aim Shams Univ. (Egypt)); Al-Murayeh, Mushabab Ayedh (Dept. of Cardiac Services, Armed Forces Hospitals Southern Region (Saudi Arabia))

    2012-05-15

    Background: Prosthetic bileaflet mechanical valve function has been traditionally evaluated using echocardiography and fluoroscopy. Multidetector computed tomography (MDCT) is a novel technique for cardiac evaluation. Purpose: To evaluate bileaflet mechanical aortic valves using a low-milliampere (mA), non-contrast MDCT protocol with a limited scan range. Material and Methods: Forty patients with a bileaflet mechanical aortic valve were evaluated using a non-contrast, low-mA, ECG-gated 64 MDCT protocol with a limited scan range. MDCT findings of opening and closing valve angles were correlated to fluoroscopy and echocardiography. Also, the valve visibility was evaluated on MDCT and fluoroscopy according to a 3-point grading scale. Results: The visualization score with the MDCT was significantly superior to the fluoroscopy (3 vs. 2.7). A strong correlation was noted between the opening (r = 0.82) and closing (r = 0.96) valve angles with MDCT and fluoroscopy without a statistically significant difference (P = 0.31 and 0.16, respectively). The mean effective radiation dose of the suggested protocol was 4 +- 0.5 mSv. Five valves were evaluated using transesophageal echocardiography because the valves were difficult to evaluate with transthoracic echocardiography, and all of these valves were evaluated optimally with MDCT. A high-pressure gradient was noted in nine valves, and the MDCT showed that seven of these valves inadequately opened, and two valves opened well, which resulted in patient valve mismatch. Incomplete valve closure was noted in five valves, and the echocardiography showed significant transvalvular regurgitation in all five valves. Conclusion: MDCT can provide a precise measurement of valve function and can potentially evaluate high-pressure gradients and transvalvular regurgitation

  7. Cellular mechanisms for the treatment of chronic heart failure: the nitric oxide- and adenosine-dependent pathways.

    Science.gov (United States)

    Minamino, Tetsuo; Kitakaze, Masafumi

    2002-05-01

    Accumulated evidence suggests that several drugs proven to improve survival in patients with chronic heart failure (CHF) enhance endogenous nitric oxide (NO)- and/or adenosine-dependent pathways. Indeed, we and others have demonstrated that: i) antagonists of either renin-angiotensin-aldosterone or beta-adrenergic systems enhance NO-dependent pathways; ii) although carvedilol and amlodipine belong to different drug classes, both of them can increase cardiac adenosine levels; iii) increased adenosine levels by dipyridamole are associated with the improvement of CHF. Interestingly, both NO and adenosine have multifactorial beneficial actions in cardiovascular systems. First of all, both of them induce vasodilation and decrease myocardial hypercontractility, which may contribute to a reduction in the severity of myocardial ischaemia. Both adenosine and NO are also involved in cardioprotection attributable to acute and late phases of ischaemic preconditioning, respectively. Secondly, they can modulate the neurohormonal systems that contribute to the progression of CHF. Thus, we propose that enhancement of endogenous NO and/or adenosine as potential therapeutic targets in a new strategy for the treatment for CHF. PMID:15989539

  8. A new dynamic 3D virtual methodology for teaching the mechanics of atrial septation as seen in the human heart

    Science.gov (United States)

    Schleich, Jean-Marc; Dillenseger, Jean-Louis; Houyel, Lucile; Almange, Claude; Anderson, Robert H.

    2009-01-01

    Background Learning embryology remains difficult, since it requires understanding of many complex phenomena. The temporal evolution of developmental events has classically been illustrated using cartoons, which create difficulty in linking spatial and temporal aspects, such correlation being the keystone of descriptive embryology. Methods We synthesized the bibliographic data from recent studies of atrial septal development. On the basis of this synthesis, consensus on the stages of atrial septation as seen in the human heart has been reached by a group of experts in cardiac embryology and paediatric cardiology. This has permitted the preparation of three-dimensional (3-D) computer graphic objects for the anatomical components involved in the different stages of normal human atrial septation. Results We have provided a virtual guide to the process of normal atrial septation, the animation providing an appreciation of the temporal and morphologic events necessary to separate the systemic and pulmonary venous returns. Conclusion We have shown that our animations of normal human atrial septation increase significantly the teaching of the complex developmental processes involved, and provide a new dynamic for the process of learning. PMID:19363807

  9. The effect of foot reflexology on physiologic parameters and mechanical ventilation weaning time in patients undergoing open-heart surgery: A clinical trial study.

    Science.gov (United States)

    Ebadi, Abbas; Kavei, Parastoo; Moradian, Seyyed Tayyeb; Saeid, Yaser

    2015-08-01

    The aim of this study was to investigate the efficacy of foot reflexology on physiological parameters and mechanical ventilation weaning time in patients undergoing open-heart surgery. This was a double blind three-group randomized controlled trial. Totally, 96 patients were recruited and randomly allocated to the experimental, placebo, and the control groups. Study groups respectively received foot reflexology, simple surface touching, and the routine care of the study setting. Physiological parameters (pulse rate, respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, percutaneous oxygen saturation) and weaning time were measured. The study groups did not differ significantly in terms of physiological parameters (P value > 0.05). However, the length of weaning time in the experimental group was significantly shorter than the placebo and the control groups (P value foot reflexology in shortening the length of weaning time. PMID:26256138

  10. Types of Heart Surgery

    Science.gov (United States)

    ... or heart wall with a patch or graft. Heart Transplant A heart transplant is surgery to remove a person's diseased heart ... a healthy heart from a deceased donor. Most heart transplants are done on patients who have end-stage ...

  11. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in ...

  12. Cyclic fatigue and fracture in pyrolytic carbon-coated graphite mechanical heart-valve prostheses: role of small cracks in life prediction.

    Science.gov (United States)

    Dauskardt, R H; Ritchie, R O; Takemoto, J K; Brendzel, A M

    1994-07-01

    A fracture-mechanics based study has performed to characterize the fracture toughness and rates of cyclic fatigue-crack growth of incipient flaws in prosthetic heart-valve components made of pyrolytic carbon-coated graphite. Such data are required to predict the safe structural lifetime of mechanical heart-valve prostheses using damage-tolerant analysis. Unlike previous studies where fatigue-crack propagation data were obtained using through-thickness, long cracks (approximately 2-20 mm long), growing in conventional (e.g., compact-tension) samples, experiments were performed on physically small cracks (approximately 100-600 microns long), initiated on the surface of the pyrolytic-carbon coating to simulate reality. Small-crack toughness results were found to agree closely with those measured conventionally with long cracks. However, similar to well-known observations in metal fatigue, it was found that based on the usual computations of the applied (far-field) driving force in terms of the maximum stress intensity, Kmax, small fatigue cracks grew at rates that exceeded those of long cracks at the same applied stress intensity, and displayed a negative dependency on Kmax; moreover, they grew at applied stress intensities less than the fatigue threshold value, below which long cracks are presumed dormant. To resolve this apparent discrepancy, it is shown that long and small crack results can be normalized, provided growth rates are characterized in terms of the total (near-tip) stress intensity (incorporating, for example, the effect of residual stress); with this achieved, in principle, either form of data can be used for life prediction of implant devices. Inspection of the long and small crack results reveals extensive scatter inherent in both forms of growth-rate data for the pyrolytic-carbon material. PMID:8083247

  13. The imbalance between oxygen demand and supply as a potential mechanism in the pathophysiology of heart failure : The role of microvascular growth and abnormalities

    NARCIS (Netherlands)

    De Boer, RA; Pinto, YM; van Veldhuisen, DJ

    2003-01-01

    In heart failure., a deficient oxygen supply often is a primary cause for myocardial dysfunction. The reverse however, may also be true; the changes that occur in the failing heart may predispose for the existence of tissue hypoxia, which further affects the function of the heart. Specifically, myoc

  14. Heart pacemaker

    Science.gov (United States)

    ... Elsevier Saunders; 2015:chap 36. Read More Arrhythmias Atrial fibrillation or flutter Cardiac ablation procedures Heart failure - overview Implantable cardioverter-defibrillator Sick sinus syndrome Wolff- ...

  15. Lungs in Heart Failure

    Directory of Open Access Journals (Sweden)

    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  16. Mechanical Circulatory Support Devices Improve Tissue Perfusion in Patients With End-Stage Heart Failure or Cardiogenic Shock

    NARCIS (Netherlands)

    C.A. den Uil; A.P. Maat; W.K. Lagrand; M. van der Ent; L.S.D. Jewbali; R.J. van Thiel; P.E. Spronk; M.L. Simoons

    2009-01-01

    Objectives: This study evaluated the effects of mechanical circulatory support (MCS) on sub-lingual microcirculation as a surrogate for splanchnic microvascular perfusion. Methods: Between May 2008 and April 2009, 10 consecutive patients received an MCS device or extracorporeal membrane oxygenation

  17. Advanced echocardiography and cardiac magnetic resonance in congenital heart disease : insights in right ventricular mechanics and clinical implications

    NARCIS (Netherlands)

    Hulst, Anna Elisabeth van der

    2011-01-01

    The thesis provides new insights into advanced echocardiographic and magnetic resonance imaging techniques for comprehensive mechanical assessment of the right ventricle in healthy children and in pediatric patients with right ventricular dysfunction. It is shown that the right ventricle does not co

  18. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970284 Effects of enalapril on heart rate variabilityin patients with congestive heart failure. ZHANGYouhua(章友华), et a1. Dept Cardiol, Cardiovasc Instit& Fuwai Hosp, CAMS & PUMC, Beijing, 100037. ChinCir J 1996; 11(2): 729-732.

  19. The Aqueous Calyx Extract of Hibiscus sabdariffa Lowers Blood Pressure and Heart Rate via Sympathetic Nervous System Dependent Mechanisms.

    Science.gov (United States)

    Aliyu, B; Oyeniyi, Y J; Mojiminiyi, F B O; Isezuo, S A; Alada, A R A

    2014-01-01

    The antihypertensive effect of Hibiscus sabdariffa (HS) has been validated in animals and man. This study tested the hypothesis that its hypotensive effect may be sympathetically mediated. The cold pressor test (CPT) and handgrip exercise (HGE) were performed in 20 healthy subjects before and after the oral administration of 15mg/Kg HS. The blood pressure (BP) and heart rate (HR) responses were measured digitally. Mean arterial pressure (MAP; taken as representative BP) was calculated. Results are expressed as mean ±SEM. P<0.05 was considered significant. CPT without HS resulted in a significant rise in MAP and HR (111.1±2.1mmHg and 100.8±2.0/min) from the basal values (97.9±1.9mmHg and 87.8±2.1/min; P<0.0001 respectively). In the presence of HS, CPT-induced changes (ΔMAP=10.1±1.7mmHg; ΔHR= 8.4±1.0/min) were significantly reduced compared to its absence (ΔMAP= 13.2±1.2mmHg; ΔHR= 13.8±1.6/min; P<0.0001 respectively). The HGE done without HS also resulted in an increase in MAP and HR (116.3±2.1mmHg and 78.4±1.2/min) from the basal values (94.8±1.6mmHg and 76.1±1.0/min; p<0.0001 respectively). In the presence of HS the HGE-induced changes (ΔMAP= 11.5±1.0mmHg; ΔHR= 3.3±1.0/min) were significantly decreased compared to its absence (ΔMAP=21.4±1.2mmHg; ΔHR= 12.8±2.0/min; P<0.0001 respectively). The CPT and HGE -induced increases in BP and HR suggest Sympathetic nervous system activation. These increases were significantly dampened by HS suggesting, indirectly, that its hypotensive effect may be due to an attenuation of the discharge of the sympathetic nervous system. PMID:26196579

  20. [Mechanobiology and the Heart].

    Science.gov (United States)

    Ishiguro, Yoshiki

    2016-05-01

    Mechanobiology has been focusing on biological research regarding mechanisms of muscle force generation, or recently sensing and response to the force applied to the tissue or each cell. Therefore, the heart has been one of the target organs and studied extensively for a long time since late 19th century. Its force-length relationship was demonstrated as the Starling's law of the heart, which is one of the most important findings in mechanobiology. In late 20th century, excitation-contraction coupling in the muscle was demonstrated and then, molecular mechanisms are gradually elucidated including calcium homeostasis and signal transductions in various situations: under the effects of catecholamines, other vasoactive agents, or ischemia. Among them, recent findings suggest possible involvement of titin, the giant elastic protein connected with both actin and myosin, with basic mechanism of the Starling's law of the heart Pathological proliferation of the heart as hypertrophic remodeling has also been extensively studied in recent years, and its signal transduction from pressure overload and volume overload to respective morphological changes of the heart chamber are partially clarified.

  1. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  2. Actualización en los mecanismos fisiopatológicos de la insuficiencia cardiaca Update in physiopathological mechanisms in heart failure

    Directory of Open Access Journals (Sweden)

    Guido Ulate-Montero

    2008-03-01

    fibrosis y de arritmias cardiacas, para lo cual es indispensable el manejo apropiado de los niveles intracelulares de Ca2+.Heart failure is one of the most frequent clinical syndromes in medical practice;it appears when the heart is unable to pump enough volume of blood to supply the tissue ’s requirements.This article reviews the most recent information regarding the mechanisms involved in the pathophysiology of heart failure,the main goal is to offer the knowledge necessary to understand and manage properly this condition.In heart failure,as a response to the low cardiac output,a series of neuroendocrine systemic mechanisms are activated,but they contribute to deteriorate the clinical status;this happens with the sympathetic and the renin-angiotensin-aldosterone systems,which end up producing endothelial damage,increase of oxidative radicals,apoptosis, cardiac fibrosis and generation of arrhythmias.Also there is an increase in the secretion of natriuretic peptides,which tend to regulate some of the exacerbated neuroendocrine responses, but with time their effect tend to diminish.At the cellular and molecular level a series of alterations occur in the regulation of intracellular Ca2+, as well as in some of the ionic currents that play a role in the generation of action potentials in cardiac myocytes.Cardiac remodeling precedes the clinical manifestations of heart failure and contributes to its deterioration.Chemical messengers like endothelin-1,norepinephrine and angiotensin II,activate the MAP kinases cascade and provoke cardiac hypertrophy favoring the development of ischemia and the appearance of arrhythmias.Pharmacological management of heart failure must aim the mechanisms affected,it must block the deleterious actions of the neuroendocrine systems,avoiding the loss of myocytes, the generation of fibrosis and the production of cardiac arrhythmias,in order to achieve this goal an appropriate management of intracellular levels of Ca2+ is required.

  3. Cardiomyocytic apoptosis and heart failure

    Institute of Scientific and Technical Information of China (English)

    Quanzhou Feng

    2008-01-01

    Heart failure is a major disease seriously threatening human health.Once left ventricular dysfunction develops,cardiac function usually deteriorates and progresses to congestive heart failure in several months or years even if no factors which accelerate the deterioration repeatedly exist.Mechanism through which cardiac function continually deteriorates is still unclear.Cardiomyocytic apoptosis can occur in acute stage of ischemic heart diseases and the compensated stage of cardiac dysfunction.In this review,we summarize recent advances in understanding the role of cardiomyocytic apoptosis in heart failure.

  4. Heart Disease

    Science.gov (United States)

    ... Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults, examines the relationship between consuming too much added sugar and the risk of heart disease death. When it Comes to Blood Pressure, Make Control ...

  5. Heart Failure

    Science.gov (United States)

    ... together. About Rise Above HF Rise Above Heart Failure seeks to increase the dialogue about HF and improve the lives of people affected by the condition through awareness, education and support. Through the initiative, AHA strives to ...

  6. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... Coronary heart disease is the leading cause of death in the United States for men and women. Coronary heart ...

  7. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008037 Factors associated with efficacy of cardiac resynchronization therapy for patients with congestive heart failure. SHI Haoying(史浩颖), et al. Dept Cardiol, Zhongshan Hosp Fudan Univ, Shanghai 200032. Chin J Cardiol 2007;35(12):1099-1163. Objective The efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated. Methods Fifty

  8. [Preparation of Ti-O Film Deposited on the Surface of a New Type of Artificial Mechanical Heart Valve].

    Science.gov (United States)

    Zhou, Feng; Cui, Yuanyuan; Wu, Liangliang; Sun, Hong; Huang, Nan

    2015-04-01

    The rutile structure titanium oxide (Ti-O) film was prepared on the pure titanium material TA2 (99.999%) surface by the magnetic filter high vacuum arc deposition sputtering source. The method can not only maintain the material mechanical properties, but also improve the surface properties for better biocompatibility to accommodate the physiological environment. The preparation process of the Ti-O film was as follows. Firstly, argon ions sputtered to the TA2 substrate surface to remove the excess impurities. Secondly, a metal ion source generated Ti ions and oxygen ions by the RF discharge. Meanwhile a certain negative bias was imposed on the sample. There a certain composition of Ti-O film was obtained under a certain pressure of oxygen in the vacuum chamber. Finally, X-ray diffraction was used to research the structure and composition of the film. The results showed that the Ti-O film of the rutile crystal structure was formed under the 0.18 Pa oxygen partial pressure. A Nano scratch experiment was used to test the coating adhesion property, which demonstrated that the film was stable and durable. The contact angle experiment and the platelet clotting experiment proved that the modified surface method had improved platelet adhesion performance, and, therefore, the material possessed better biocompatibility. On the whole, the evaluations proved the modified material had excellent performance. PMID:26211266

  9. The pathophysiology of heart failure.

    Science.gov (United States)

    Kemp, Clinton D; Conte, John V

    2012-01-01

    Heart failure is a clinical syndrome that results when the heart is unable to provide sufficient blood flow to meet metabolic requirements or accommodate systemic venous return. This common condition affects over 5 million people in the United States at a cost of $10-38 billion per year. Heart failure results from injury to the myocardium from a variety of causes including ischemic heart disease, hypertension, and diabetes. Less common etiologies include cardiomyopathies, valvular disease, myocarditis, infections, systemic toxins, and cardiotoxic drugs. As the heart fails, patients develop symptoms which include dyspnea from pulmonary congestion, and peripheral edema and ascites from impaired venous return. Constitutional symptoms such as nausea, lack of appetite, and fatigue are also common. There are several compensatory mechanisms that occur as the failing heart attempts to maintain adequate function. These include increasing cardiac output via the Frank-Starling mechanism, increasing ventricular volume and wall thickness through ventricular remodeling, and maintaining tissue perfusion with augmented mean arterial pressure through activation of neurohormonal systems. Although initially beneficial in the early stages of heart failure, all of these compensatory mechanisms eventually lead to a vicious cycle of worsening heart failure. Treatment strategies have been developed based upon the understanding of these compensatory mechanisms. Medical therapy includes diuresis, suppression of the overactive neurohormonal systems, and augmentation of contractility. Surgical options include ventricular resynchronization therapy, surgical ventricular remodeling, ventricular assist device implantation, and heart transplantation. Despite significant understanding of the underlying pathophysiological mechanisms in heart failure, this disease causes significant morbidity and carries a 50% 5-year mortality. PMID:22227365

  10. Right heart failure: toward a common language.

    Science.gov (United States)

    Mehra, Mandeep R; Park, Myung H; Landzberg, Michael J; Lala, Anuradha; Waxman, Aaron B

    2013-12-01

    In this guideline, the International Right Heart Foundation Working Group moves a step forward to develop a common language to describe the development and defects that exemplify the common syndrome of right heart failure. We first propose fundamental definitions of the distinctive components of the right heart circulation and provide consensus on a universal definition of right heart failure. These definitions will form the foundation for describing a uniform nomenclature for right heart circulatory failure with a view to foster collaborative research initiatives and conjoint education in an effort to provide insight into mechanisms of disease unique to the right heart. PMID:25006413

  11. The new application of photosensitization reaction to atrial fibrillation treatment: mechanism and demonstration of non-thermal electrical conduction block with porcine heart

    Science.gov (United States)

    Ito, Arisa; Matsuo, Hiroki; Suenari, Tsukasa; Kajihara, Takuro; Kimura, Takehiro; Miyoshi, Shunichiro; Ogawa, Satoshi; Arai, Tsunenori

    2009-06-01

    We have proposed non-thermal electrical conduction block for atrial fibrillation treatment by the photosensitization reaction, in which the interval time between the photosensitizer injection and irradiation is less than tenth of that in conventional way. To study the mechanism of photosensitization reaction-induced electrical conduction block, intracellular Ca2+ concentration change in rat myocardial cells was measured by fluorescent Ca2+ indicator Fluo-4 AM with confocal laser microscopy. Measured rapid increase in the fluorescence intensity and a change in cell morphology indicated that cell membrane damage; that is Ca2+ influx and eventually cell death caused by the photosensitization reaction. To demonstrate myocardial electrical conduction block induced by the photosensitization reaction, surgically exposed porcine heart under deep anesthesia was used. The myocardial tissue was paced with a stimulation electrode. The propagated electrical signals were measured by bipolar electrodes at two different positions. Thirty minutes after the injection of 5-10 mg/kg Porfimer sodium or Talaporfin sodium, the red laser light was irradiated to the tissue point by point crossing the measuring positions by the total energy density of less than 200 J/cm2. The electrical signal conduction between the measuring electrodes in the myocardial tissue was delayed by each irradiation procedure. The electrical conduction delay corresponded to the block line length was obtained. These results demonstrated the possibility of non-thermal electrical conduction block for atrial fibrillation treatment by the photosensitization reaction.

  12. The effect of adrenaline and high Ca2+ on the mechanical performance and oxygen consumption of the isolated perfused trout (Oncorhynchus mykiss) heart

    DEFF Research Database (Denmark)

    Rytter, Dorte; Gesser, Hans

    2007-01-01

    In heart muscle from mammals, catecholamines frequently evoke an oxygen waste and reduce efficiency. It was examined if this also applies to fish in which heart muscle activity is often restricted by oxygen availability. In the isolated perfused heart from rainbow trout, adrenaline (0.5 micro......M) increased power output by approximately 97%, when afterload was adjusted to maximum both before and after adrenaline addition, and by approximately 68%, when afterload remained at the maximum obtained before adrenaline addition. Oxygen consumption was enhanced by a similar amount (approximately 70%) in both...... situations. Hence, efficiency, i.e. power output/oxygen consumption, increased significantly from 25 to 30% for the heart always exposed to maximal afterload, whereas it stayed unchanged at 24% for the heart exposed to control afterload only. Adrenaline increases the Ca2+ activity participating in activation...

  13. The Basic Mechanism of Beta-blocker in Chronic Heart Failure%β受体阻断剂在慢性心衰中作用的基础机制

    Institute of Scientific and Technical Information of China (English)

    刘伟

    2011-01-01

    心力衰竭是很多心血管疾病的最终阶段,也是常见的致死原因之一.心力衰竭时起代偿作用的交感神经系统的持续兴奋是导致心力衰竭恶化的一个重要原因.近年来,众多临床试验证实β受体阻断剂类药物对心力衰竭有良好的治疗作用,β受体阻断剂能通过慢性抑制交感神经的兴奋,改善心力衰竭患者心功能,从而减少患者病死率,增加生存率.%Heart failure is the final phase for many cardiovascular diseases , one of the common fatal causes as well. One important reason of heart failure deterioration is the sustained excitement of sympathetic nervous system which is a compensatory mechanism in heart failure. In recent years,evidence has been accumulated on the beneficial actions of beta-blockers in patients with heart failure. The effect of beta-blocker in chronic inhibition of sympathetic nervous system can improve cardiac function of heart failure patients , reduce mortality and increase survival rates.

  14. The effect of pre-existing pulmonary vascular disease on the response to mechanical ventilation with PEEP following open-heart surgery.

    Science.gov (United States)

    Trichet, B; Falke, K; Togut, A; Laver, M B

    1975-01-01

    The effects of mechanical ventilation with and without positive end-expiratory pressure (PEEP) on hemodynamic performance and blood-gas exchange were studied in ten patients following open-heart surgery. Ventilation at constant tidal volume (15 ml/kg body weight) with 10 cm H2O PEEP following aortic valve replacement (AVR) IN FIVE PATIENTs without pulmonary vascular disease was associated with the following significant changes: a rise in arterial Po2, a fall in the alveolar-arterial Po2 gradient when Fio2 = 1.0, decreases in calculated Qs/Qt and cardiac index. Using a similar pattern of ventilation following mitral valve replacement (MVR) in patients with elevated pulmonary vascular resistance, we found a significant decrease in cardiac index (but less than in the AVR group), a significant elevation of calculated physiologic deadspace (Vd/Vt) and no change in Qs/Qt. An hour after removal of PEEP, intravascular pressures, blood flow and blood-gas exchange values of all patients with AVR had returned to control levels; patients with MVR had persistently significantly low cardiac indices, while Vd/Vt returned to pre-PEEP values. These findings suggest that evaluation of responses to different ventilation patterns must take into account pre-existing V/Q abnormalities secondary to pulmonary vascular disease, particularly when these are secondary to chronic congestive heart failure. Following AVR, Qs/Qt changed in the same direction as cardiac index (CI) irrespective of ventilatory pattern: CI decreased and rose as CI increased. The authors conclude that with increasing severity of pulmonary vascular disease, changes in airway pressure will have an unpredictable effect on cardiac index unless the level of myocardial competence is taken into account. In the presence of ventricular failure, changes in pleural (and therefore transmural) pressures will be minimal compared with the high filling pressures and exert no influence on stroke volume. Although pulmonary venous

  15. Negative impact of β-arrestin-1 on post-myocardial infarction heart failure via cardiac and adrenal-dependent neurohormonal mechanisms.

    Science.gov (United States)

    Bathgate-Siryk, Ashley; Dabul, Samalia; Pandya, Krunal; Walklett, Karlee; Rengo, Giuseppe; Cannavo, Alessandro; De Lucia, Claudio; Liccardo, Daniela; Gao, Erhe; Leosco, Dario; Koch, Walter J; Lymperopoulos, Anastasios

    2014-02-01

    β-Arrestin (βarr)-1 and β-arrestin-2 (βarrs) are universal G-protein-coupled receptor adapter proteins that negatively regulate cardiac β-adrenergic receptor (βAR) function via βAR desensitization and downregulation. In addition, they mediate G-protein-independent βAR signaling, which might be beneficial, for example, antiapoptotic, for the heart. However, the specific role(s) of each βarr isoform in cardiac βAR dysfunction, the molecular hallmark of chronic heart failure (HF), remains unknown. Furthermore, adrenal βarr1 exacerbates HF by chronically enhancing adrenal production and hence circulating levels of aldosterone and catecholamines. Herein, we sought to delineate specific roles of βarr1 in post-myocardial infarction (MI) HF by testing the effects of βarr1 genetic deletion on normal and post-MI cardiac function and morphology. We studied βarr1 knockout (βarr1KO) mice alongside wild-type controls under normal conditions and after surgical MI. Normal (sham-operated) βarr1KO mice display enhanced βAR-dependent contractility and post-MI βarr1KO mice enhanced overall cardiac function (and βAR-dependent contractility) compared with wild type. Post-MI βarr1KO mice also show increased survival and decreased cardiac infarct size, apoptosis, and adverse remodeling, as well as circulating catecholamines and aldosterone, compared with post-MI wild type. The underlying mechanisms, on one hand, improved cardiac βAR signaling and function, as evidenced by increased βAR density and procontractile signaling, via reduced cardiac βAR desensitization because of cardiac βarr1 absence, and, on the other hand, decreased production leading to lower circulating levels of catecholamines and aldosterone because of adrenal βarr1 absence. Thus, βarr1, via both cardiac and adrenal effects, is detrimental for cardiac structure and function and significantly exacerbates post-MI HF.

  16. Computer Simulation of the Beating Human Heart

    Science.gov (United States)

    Peskin, Charles S.; McQueen, David M.

    2001-06-01

    The mechanical function of the human heart couples together the fluid mechanics of blood and the soft tissue mechanics of the muscular heart walls and flexible heart valve leaflets. We discuss a unified mathematical formulation of this problem in which the soft tissue looks like a specialized part of the fluid in which additional forces are applied. This leads to a computational scheme known as the Immersed Boundary (IB) method for solving the coupled equations of motion of the whole system. The IB method is used to construct a three-dimensional Virtual Heart, including representations of all four chambers of the heart and all four valves, in addition to the large arteries and veins that connect the heart to the rest of the circulation. The chambers, valves, and vessels are all modeled as collections of elastic (and where appropriate, actively contractile) fibers immersed in viscous incompressible fluid. Results are shown as a computer-generated video animation of the beating heart.

  17. Do neonatal mouse hearts regenerate following heart apex resection?

    DEFF Research Database (Denmark)

    Andersen, Ditte Caroline; Ganesalingam, Suganya; Jensen, Charlotte Harken;

    2014-01-01

    strains and found no evidence of complete regeneration. Ideally, new functional cardiomyocytes, endothelial cells, and vascular smooth muscle cells should be formed in the necrotic area of the damaged heart. Here, damaged hearts were 9.8% shorter and weighed 14% less than sham controls. In addition......The mammalian heart has generally been considered nonregenerative, but recent progress suggests that neonatal mouse hearts have a genuine capacity to regenerate following apex resection (AR). However, in this study, we performed AR or sham surgery on 400 neonatal mice from inbred and outbred......, the resection border contained a massive fibrotic scar mainly composed of nonmyocytes and collagen disposition. Furthermore, there was a substantial reduction in the number of proliferating cardiomyocytes in AR hearts. Our results thus question the usefulness of the AR model for identifying molecular mechanisms...

  18. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009170 Curcumin attenuates left ventricular dysfunction and remodeling in rabbits with chronic heart failure. TANG Yanhong(唐艳红),et al.Dept Cardiol,Renmin Hosp,Wuhan Univ,Wuhan 430060.Chin J Cardiol,2009;37(3):262-267.

  19. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  20. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  1. Heart disease - resources

    Science.gov (United States)

    Resources - heart disease ... The following organizations are good resources for information on heart disease: American Heart Association -- www.heart.org Centers for Disease Control and Prevention -- www.cdc.gov/heartdisease

  2. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular heartbeats, called ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  3. Heart disease and diet

    Science.gov (United States)

    Diet - heart disease ... diet and lifestyle can reduce your risk of: Heart disease, heart attacks, and stroke Conditions that lead to heart disease, including high cholesterol , high blood pressure, and obesity ...

  4. Heart Attack Risk Assessment

    Science.gov (United States)

    ... Pressure Tools & Resources Stroke More Heart Attack Risk Assessment Updated:May 31,2016 We're sorry, but ... Can You Recognize a Heart Attack? Quiz Risk Assessment Patient Information Sheets: Heart Attack Heart Attack Personal ...

  5. Heart pacemaker - discharge

    Science.gov (United States)

    ... Elsevier Saunders; 2014:chap 36. Read More Arrhythmias Atrial fibrillation or flutter Cardiac ablation procedures Coronary heart disease Heart bypass surgery Heart bypass surgery - minimally invasive Heart failure - overview High blood cholesterol levels Sick sinus syndrome ...

  6. Heart and Stroke Encyclopedia

    Science.gov (United States)

    ... Y Z What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

  7. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  8. What Causes Heart Block?

    Science.gov (United States)

    ... or inflammation of the heart muscle. Heart failure . Rheumatic (roo-MAT-ik) fever. Cardiomyopathy (KAR-de-o-mi-OP-a-the), or heart muscle diseases. Other diseases may increase the risk of heart ...

  9. Mitophagy and heart failure

    OpenAIRE

    Shires, Sarah E.; Gustafsson, Åsa B.

    2015-01-01

    Cardiac mitochondria are responsible for generating energy in the form of ATP through oxidative phosphorylation and are crucial for cardiac function. Mitochondrial dysfunction is a major contributor to loss of myocytes and development of heart failure. Myocytes have quality control mechanisms in place to ensure a network of functional mitochondria. Damaged mitochondria are degraded by a process called mitochondrial autophagy, or mitophagy, where the organelle is engulfed by an autophagosome a...

  10. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  11. Satellite Heart

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The usefulness of China’s own global navigation system is being extended by technological breakthroughs China has successfully developed the country’s first navigation chip that is expected to be the heart of the country’s satellite-based navigation system,according to a report released on February 21. The Navigation I chip,developed by the Shanghai Fukong Hualong Micro-system

  12. Cardiac mechanics and ventricular twist by three-dimensional strain analysis in relation to B-type natriuretic peptide as a clinical prognosticator for heart failure patients.

    Directory of Open Access Journals (Sweden)

    Sheng-Nan Chang

    Full Text Available BACKGROUND: Three dimensional (3D echocardiography-derived measurements of myocardial deformation and twist have recently advanced as novel clinical tools. However, with the exception of left ventricular ejection fraction and mass quantifications in hypertension and heart failure populations, the prognostic value of such imaging techniques remains largely unexplored. METHODS: We studied 200 subjects (mean age: 60.2±16 years, 54% female, female n = 107 with known hypertension (n = 51, diastolic heart failure (n = 61, or systolic heart failure (n = 30, recruited from heart failure outpatient clinics. Fifty-eight healthy volunteers were used as a control group. All participants underwent 3D-based myocardial deformation and twist analysis (Artida, Toshiba Medical Systems, Tokyo, Japan. We further investigated associations between these measures and brain natriuretic peptide levels and clinical outcomes. RESULTS: The global 3D strain measurements of the healthy, hypertension, diastolic heart failure, and systolic heart failure groups were 28.03%, 24.43%, 19.70%, and 11.95%, respectively (all p<0.001. Global twist measurements were estimated to be 9.49°, 9.77°, 8.32°, and 4.56°, respectively. We observed significant differences regarding 3D-derived longitudinal, radial, and global 3D strains between the different disease categories (p<0.05, even when age, gender, BMI and heart rate were matched. In addition, 3D-derived longitudinal, circumferential, and 3D strains were all highly correlated with brain natriuretic peptide levels (p<0.001. At a mean 567.7 days follow-up (25th-75th IQR: 197-909 days, poorer 3D-derived longitudinal, radial, and global 3D strain measurements remained independently associated with a higher risk of cardiovascular related death or hospitalization due to heart failure, after adjusting for age, gender, and left ventricular ejection fraction (all p<0.05. CONCLUSIONS: 3D-based strain analysis may be a

  13. Ventricular assist device in univentricular heart physiology.

    Science.gov (United States)

    Brancaccio, Gianluca; Gandolfo, Fabrizio; Carotti, Adriano; Amodeo, Antonio

    2013-04-01

    The use of mechanical cardiac assistance is well established as a bridge to orthotopic heart transplantation (OHT) or to recovery for patients with congestive heart failure, however, the experience in single ventricle (SV) physiology is still limited. We report two cases of mechanical assistance in patients with SV physiology: a 2-year old male with hypoplastic left heart syndrome who underwent Norwood Stage I and II followed by HF and a 4-year old female with a univentricular heart who developed a severe right ventricular dysfunction 2 years after a cavopulmonary shunt. Mechanical support utilizing ventricular assist devices (VADs) is considered a valid tool to bridge patients with congestive heart failure to either OHT or to recovery. Increasing experience and improved outcomes utilizing this technology in children with biventricular hearts have led to considering employing these devices in failing SV treatment. We present 2 cases of terminally ill children with SV who were assisted with a VAD.

  14. Mechanism of sphingosine-1-phosphate induced cardioprotection against I/R injury in diabetic rat heart: Possible involvement of glycogen synthase kinase 3β and mitochondrial permeability transition pore.

    Science.gov (United States)

    Rana, Ajay; Sharma, Saurabh

    2016-02-01

    There is growing evidence that diabetes mellitus causes attenuation of the bioactive metabolite of membrane sphingolipids, sphingosine-1-phosphate, and this may be a key mechanism in the decreased cardioprotective effect of ischaemic preconditioning (IPC) in the diabetic heart. Thus, this study has been designed to investigate the role and pharmacological potential of sphingosine-1-phosphate in diabetic rat heart. Diabetes was produced in Wistar rats by administration of a low dose of streptozotocin (STZ) (35 mg/kg, i.p., once) and feeding a high fat diet (HFD) for 6 weeks. Isolated rat heart was subjected to 30 min ischaemia followed by 120 min of reperfusion (I/R). The heart was subjected to pre-ischaemic treatment (before ischaemia for 20 min) and pharmacological preconditioning with the S1P agonist FTY720 (0.6 μmol/L) with and without atractyloside (an mPTP opener; in the last episode of reperfusion before I/R). Myocardial infarction was assessed in terms of increase in lactate dehydrogenase (LDH), creatinine kinase-MB (CK-MB), myeloperoxidase (MPO) level and infarct size (triphenyltetrazolium chloride staining). Immunohistochemistry analysis was done for assessment of tumour necrosis factor (TNF)-α and glycogen synthase kinase (GSK)-3β level in cardiac tissue. Pre-ischaemic treatment and pharmacological preconditioning with FTY720 significantly decreased I/R-induced myocardial infarction, TNF-alpha, GSK-3β level and release of LDH and CK-MB as compared to control group. The cardioprotective effect of S1P agonist was significantly attenuated by atractyloside. It may be concluded that S1P agonist FTY720 prevents the diabetic heart from ischaemic reperfusion injury, possibly through inhibition of GSK-3β and regulation of opening of mitochondrial permeability transition pore. PMID:26582369

  15. Microstructure of Silicon-alloyed Pyrocarbon for Mechanical Heart Valves%人工心瓣含硅热解炭涂层的微观结构

    Institute of Scientific and Technical Information of China (English)

    张建辉; 孙海博; 王根明; 郭鹏海

    2011-01-01

    为了研究人工心瓣含硅热解炭涂层的微观结构,利用准稳态流化床反应装置制备出了含硅热解炭涂层,利用X射线衍射(XRD)、X射线能谱仪(EDS)、扫描电镜(SEM)、透射电镜(TEM)和偏光显微镜(PLM)对涂层微观结构进行了表征.结果表明,该涂层材料只有乱层结构热解炭和β型碳化硅两种物相,主要由直径为300 nm ~1μm的球形颗粒状碳结构组成,球形颗粒之间由片层状碳结构紧密相连,偶尔会形成闭合孔洞(直径约为0.1 ~1μm).涂层中硅元素宏观均匀分布且含量适中(6.48 wt%),直径约6~8nm的β型碳化硅晶粒无规则取向分布且存在微观尺度的集聚现象.含硅热解炭涂层的这些结构特征决定了其均匀致密、宏观各向同性的特性.%In order to study microstructure of silicon-alloyed pyrocarbon for mechanical heart valves, the silicon-alloyed pyrocarbon coating was prepared by a quasi-steady-state fluidized bed reactor. Microstructure of the coating was investigated by X-ray diffraction ( XRD ) , X-ray energy dispersive spectrometer ( EDS ) , scanning electron microscopy ( SEM ) , transmission electron microscopy ( TEM) and polarized light microscopy ( PLM). The results showed that the coating consisted of two phases, turbostratic pyrocarbon and (3 silicon carbide (β-SiC) , and was mainly composed of spherical particles that were from 300 nm to 1 μm in diameter. These spherical particles, between which there were occasionally pores (about 0. 1 - 1 μm in diameter) , were welded by laminar carbons. The silicon element whose content was moderate (6. 48 wt% ) distributed macro-unifonnly in the coating. The β-SiC grains about 6-8 nm in grain size distributed with random orientation and had some micro-scale agglomeration. These structural features of the silicon-alloyed pyrocarbon coating determined its uniform, dense and macroscopically isotropic properties.

  16. Revealing Hearts

    DEFF Research Database (Denmark)

    Saghaug, Kristin Falck; Pattison, George; Lindgren, Peter

    2014-01-01

    Some small business owners want to balance personal values as well as economic values. “I have to follow my heart” or “it must be meaningful” some of them say. But how might they be able to know what gives meaning to the heart? The philosophical theologian Paul Tillich finds that the problem is......, in business life. In Tillich’s own terms, even preliminary concerns may point at an ultimate concern (Tillich, 1964), which can also be understood as ‘knowledge of the heart’. Our account is also connected to wider discussions concerning the nature of intuition....

  17. Biological heart valves.

    Science.gov (United States)

    Ciubotaru, Anatol; Cebotari, Serghei; Tudorache, Igor; Beckmann, Erik; Hilfiker, Andres; Haverich, Axel

    2013-10-01

    Cardiac valvular pathologies are often caused by rheumatic fever in young adults, atherosclerosis in elderly patients, or by congenital malformation of the heart in children, in effect affecting almost all population ages. Almost 300,000 heart valve operations are performed worldwide annually. Tissue valve prostheses have certain advantages over mechanical valves such as biocompatibility, more physiological hemodynamics, and no need for life-long systemic anticoagulation. However, the major disadvantage of biological valves is related to their durability. Nevertheless, during the last decade, the number of patients undergoing biological, rather than mechanical, valve replacement has increased from half to more than three-quarters for biological implants. Continuous improvement in valve fabrication includes development of new models and shapes, novel methods of tissue treatment, and preservation and implantation techniques. These efforts are focused not only on the improvement of morbidity and mortality of the patients but also on the improvement of their quality of life. Heart valve tissue engineering aims to provide durable, "autologous" valve prostheses. These valves demonstrate adaptive growth, which may avoid the need of repeated operations in growing patients.

  18. The mechanical heart valve replacement surgery in the treatment of rheumatic heart disease in patients with atrial fibril ation psychological care%机械瓣膜替换术治疗风湿性心脏病合并心房颤动患者的心理护理

    Institute of Scientific and Technical Information of China (English)

    易红梅; 杜建文; 胡丽娟; 徐丽; 冯丽花

    2013-01-01

    目的:探讨使用机械瓣膜替换手术治疗风湿性心脏病合并房颤患者手术后给予心理护理的效果。方法以78例风湿性心脏病合并房颤患者为临床研究对象,患者均采用机械瓣膜替换手术,对照组给予常规护理,实验组给予围手术期心理护理,对比观察患者的护理效果。结果实验组患者围手术期心理焦虑程度较低,患者睡眠质量更好,出院后生活幸福感高,与对照组比较有显著差异,p<0.05。结论在机械瓣膜替换术治疗风湿性心脏病合并心房颤动患者护理工作中加强心理护理具有较好的效果。%Objective: To investigate the effect of psychological care given after surgical treatment of rheumatic heart disease in patients with atrial fibril ation surgery using a mechanical valve replacement. : 78 patients with rheumatic heart disease patients with atrial fibril ation clinical study, patients were treated with mechanical heart valve replacement surgery, the control group received conventional care, the experimental group were given perioperative psychological care, compared to observe the effect of the patient's care. Results: The experimental group patients perioperative the mental anxiety level is lower, the better quality of sleep in patients, the happiness of life after discharge, compared with the control group, a significant difference, p <0.05. Conclusion: The mechanical heart valve replacement surgery in the treatment of rheumatic heart disease in patients with atrial fibril ation care, strengthen psychological care with good results.

  19. [Metabolic therapy for heart failure].

    Science.gov (United States)

    Loiacono, Ferdinando; Alberti, Luca; Lauretta, Ludovica; Puccetti, Patrizia; Silipigni, Carmen; Margonato, Alberto; Fragasso, Gabriele

    2014-01-01

    Heart failure may promote metabolic changes such as insulin resistance, in part through neurohumoral activation, and determining an increased utilization of non-carbohydrate substrates for energy production. In fact, fasting blood ketone bodies as well as fat oxidation have been shown to be increased in patients with heart failure. The result is depletion of myocardial ATP, phosphocreatine and creatine kinase with decreased efficiency of mechanical work. A direct approach to manipulate cardiac energy metabolism consists in modifying substrate utilization by the failing heart. To date, the most effective metabolic treatments include several pharmacological agents that directly inhibit fatty acid oxidation. The results of current research are supporting the concept that shifting the energy substrate preference away from fatty acid metabolism and toward glucose metabolism could be an effective adjunctive treatment in patients with heart failure. Trimetazidine is the most studied drug in this context. Several small studies have evidenced the usefulness of such additional therapeutic tools for heart failure. More specifically, recent meta-analyses and a multicenter retrospective study have shown that additional use of trimetazidine in patients with heart failure, along with symptoms and cardiac function improvement, also provides a significant protective effect on all-cause mortality, cardiovascular events and hospitalization due to cardiac causes. Nevertheless, the exact role of metabolic therapy in heart failure is yet to be established, and a large multicenter randomized trial is necessary. PMID:25072544

  20. Pediatric cardiology. Clinical and practical experiences with heart diseases of children, juveniles and young adults

    International Nuclear Information System (INIS)

    The book on pediatric cardiology covers the following chapters: (I) Fundamentals and diagnostics: pediatric cardiologic anamnesis, electrocardiograms, thorax X-radiography, MRT and CT of the heart, nuclear medical diagnostics, exercise tests, heart catheter examination, electrophysiological tests. (II) Leading symptoms: Cyanosis, cardiac murmur, thorax pain, palpitation, syncopes. (III) Disease pictures: congenital heart defects, acquired heart defects, cardiomyopathies, heart rhythm disturbances, heart insufficiency, arterial hypertension, pulmonary hypertension, other heart involving syndromes. (IV) Therapy: Catheter interventional therapy, post-surgical pediatric cardiac therapy, surgery involving the life-support machine, mechanical cardiovascular support systems, initial treatment of newborns with critical heart defects, heart transplantation, vaccination of children with heart diseases, medicinal therapy.

  1. Heart Healthy Eating

    Science.gov (United States)

    ... disease fact sheet Heart health and stroke Heart-healthy eating Heart-healthy eating is an important way to lower your risk ... and unhealthy fats. Expand All Why is heart-healthy eating important? Heart-healthy eating, along with regular exercise ...

  2. Therapeutic options in chronic heart failure. Findings on chest X-ray

    International Nuclear Information System (INIS)

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  3. Inhaled nitric oxide versus aerosolized iloprost in secondary pulmonary hypertension in children with congenital heart disease: vasodilator capacity and cellular mechanisms

    OpenAIRE

    Rimensberger, Peter; Spahr-Schopfer, Isabelle; Berner, Michel; Jaeggi, Edgard; Kalangos, Afksendiyos; Friedli, Beat; Beghetti, Maurice

    2001-01-01

    Inhaled nitric oxide (iNO) has been used to assess the vasodilator capacity of the pulmonary vascular bed in children with congenital heart disease and elevated pulmonary vascular resistance. Inhaled iloprost is a pulmonary vasodilator for the long-term treatment of pulmonary hypertension (PHT). Because these 2 vasodilators act through different pathways (release of cGMP or cAMP, respectively), we compared the pulmonary vasodilator capacity of each.

  4. [NO-DEPENDENT MECHANISM OF THE CARDIOPROTECTIVE ACTION OF PHENIBUT ON STRESS-INDUCED VIOLATION OF CONTRACTILE FUNCTION OF THE HEART].

    Science.gov (United States)

    Tyurenkov, I N; Perfilova, V N; Sadikova, N V; Prokofiev, I I

    2015-01-01

    A stressor action for 24 h reduces both ino- and chronotropic reserves of animal heart as evidenced by a decrease in rate growth increments of contraction and relaxation of the myocardium, left ventricular pressure (LVP), heart rate, and the maximum intensity of functioning (MIF) as compared to intact animals during testing for adrenoreactivity and maximum isometric load caused by clamping of the ascending part of the aortic arch. Blockade of NO-synthase leads to a high percentage of animal death during the stressor action, anesthesia, opening of the chest, and functional tests and causes marked reduction in the growth rates of contraction (+dP/dt max) and relaxation (-dP/dt max) speed, LVP, heart rate, and MIF--on the average about 2 times (p Phenibut limits stress-induced violations of the myocardium contractility, as indicated by a higher growth of performance in stress tests--on the average about 1.8 times (p phenibut is less pronounced when it is introduced on the background of the blockade of NO-ergic system. Under these conditions, there are cases of animal death, predominantly during the stressor action. The results obtained suggest that, for ensuring cardioprotective action of phenibut under conditions of stress-induced myocardial damage, it is necessary to provide for participation of nitric oxide system. PMID:27017698

  5. Hypothyroidism and Heart Disease

    Science.gov (United States)

    ... Hypothyroidism and Heart Disease Fact Sheet Hypothyroidism and Heart Disease January 2014 Download PDFs English Espanol Editors Alan ... hormone. Why does hypothyroidism increase your risk for heart disease? Both thyroid hormones (T4 and T3) are related ...

  6. About Heart Attacks

    Science.gov (United States)

    ... heart muscle can impact how well the heart pumps blood throughout the body. The degree of loss of ... chambers suddenly start beating chaotically and don't pump blood. Death occurs within minutes after the heart stops. ...

  7. Heart Attack Recovery FAQs

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Heart Attack Recovery FAQs Updated:Aug 24,2016 Most people ... recovery. View an animation of a heart attack . Heart Attack Recovery Questions and Answers What treatments will I ...

  8. What Causes Heart Murmurs?

    Science.gov (United States)

    ... and get carried to the heart can sometimes infect the inner surface of the heart, including the heart valves. This rare but sometimes life-threatening infection is called infective endocarditis (EN-do-kar-DI-tis), or IE. IE ...

  9. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... is defined as: 4 ounces (113 grams) of wine 12 ounces (340 grams) of beer 1 ounce ( ...

  10. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... then moved through the aortic valve into the left side of your heart. The pressure is measured ... coronary angiography) Take x-ray pictures of the left side of the heart (ventriculography)

  11. In Vitro Study of Flow Regulation for Pulmonary Insufficiency

    OpenAIRE

    Camp, T. A.; Stewart, K. C.; Figliola, R.S.; McQuinn, T.

    2007-01-01

    Given the tolerance of the right heart circulation to mild regurgitation and gradient, we study the potential of using motionless devices to regulate the pulmonary circulation. In addition, we document the flow performance of two mechanical valves. A motionless diode, a nozzle, a mechanical bileaflet valve, and a tilting disk valve were tested in a pulmonary mock circulatory system over the normal human range of pulmonary vascular resistance (PVR). For the mechanical valves, regurgitant fract...

  12. High Altitude and Heart

    Directory of Open Access Journals (Sweden)

    Murat Yalcin

    2011-04-01

    Full Text Available Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [TAF Prev Med Bull 2011; 10(2.000: 211-222

  13. [Competence Network Heart Failure (CNHF). Together against heart failure].

    Science.gov (United States)

    Ertl, Georg; Störk, Stefan; Börste, Rita

    2016-04-01

    Heart failure is one of the most urgent medical and socio-economic challenges of the 21(st) century. Up to three million people are affected in Germany; this means one in ten people over the age of 65  live with heart failure. The current demographic changes will accentuate the importance of this grave health problem. The care of patients with heart failure, as well as the associated research mandates a comprehensive, multidisciplinary approach. The Competence Network Heart Failure (CNHF) pursues this objective. CNHF is a research alliance with 11 sites in Germany and was funded by the Federal Ministry of Research (BMBF) from 2003 through 2014. Since January 2015, the network has been an associate cooperating partner of the German Centre for Cardiovascular Research (DZHK). During the 12-year funding period by the BMBF, scientists in the field of heart failure from 30 university hospitals, 5 research institutes, 7 heart centers, 17 cardiovascular clinics, over 200 general practitioners, 4 rehabilitation clinics, as well as numerous organizations and associations were involved in cooperative CNHF research. In the context of 22 projects, the CNHF covered basic, clinical, and health care research, and generated numerous groundbreaking insights into disease mechanisms, as well as diagnosis and treatment of heart failure, which are documented in more than 350 publications. With its central study database and bank of biomaterials, the network has set up a Europe-wide unique research resource, which can be used in the future for national and international cooperations with the DZHK and other partners. Furthermore, the CNHF strongly promotes nation- and Europe-wide public relations and heart failure awareness activities. PMID:26979718

  14. Sites and mechanisms responsible for the low rate of free radical production of heart mitochondria in the long-lived pigeon.

    Science.gov (United States)

    Herrero, A; Barja, G

    1997-11-01

    Basal (substrate alone) and maximum rates of H2O2 production, oxygen consumption and free radical leak in the respiratory chain were higher in heart mitochondria of the short-lived rat (4 years) than in the long-lived pigeon (35 years). This suggests that the low free radical production of pigeon heart mitochondria is due in part to both a low electron flow and a low percent leak of electrons out of sequence in the respiratory chain. Thenoyltrifluoroacetone did not increase H2O2 production with succinate either in rats or pigeons. Mitochondrial H2O2 production was higher with pyruvate/malate than with succinate in both animal species. Rotenone and antimycin A increased H2O2 production with pyruvate/malate to the maximum levels observed in each species. Addition of myxothiazol to antimycin A-treated mitochondria supplemented with pyruvate/malate decreased H2O2 production in both species. All the combinations of inhibitors added with pyruvate/malate resulted in higher rates of H2O2 production in rats than in pigeons. When succinate instead of pyruvate/malate was used as substrate, rotenone and thenoyltrifluoroacetone decreased mitochondrial H2O2 production in the rat and did not change it in the pigeon. The results indicate that Complexes I and III are the main H2O2 generators of heart mitochondria in rats and pigeons and that both Complexes are responsible for the low H2O2 production of the bird. p-Chloromercuribenzoate and ethoxyformic anhydride strongly inhibited the H2O2 production induced by rotenone with pyruvate/malate in both species. This suggests that the free radical generator of Complex I is located after the ferricyanide reduction site, between the ethoxyformic and the rotenone-sensitive sites.

  15. Heart failure: SGLT2 inhibitors and heart failure -- clinical implications.

    Science.gov (United States)

    Raz, Itamar; Cahn, Avivit

    2016-04-01

    The latest findings from the EMPA-REG OUTCOME trial show a 34% reduction in hospitalization for heart failure or cardiovascular death in patients receiving empagliflozin, a sodium/glucose cotransporter 2 (SGLT2) inhibitor, compared with placebo. These outstanding results call for discussion of the clinical implications, and in-depth studies of the mechanisms of action of SGLT2 inhibitors. PMID:26961066

  16. Smoking, Stress, and Coronary Heart Disease.

    Science.gov (United States)

    Epstein, Leonard H.; Perkins, Kenneth A.

    1988-01-01

    Focuses on the interrelation between stressors and smoking, and on its potential impact on coronary heart disease risk beyond that due to stressors or to smoking alone. Reviews evidence supporting the stress-smoking interrelationship, its relevance to the risk of heart disease, and mechanisms explaining why smokers smoke more during stress and why…

  17. Evolutionary anticipation of the human heart.

    OpenAIRE

    Victor, S; Nayak, V. M.

    2000-01-01

    We have studied the comparative anatomy of hearts from fish, frog, turtle, snake, crocodile, birds (duck, chicken, quail), mammals (elephant, dolphin, sheep, goat, ox, baboon, wallaby, mouse, rabbit, possum, echidna) and man. The findings were analysed with respect to the mechanism of evolution of the heart.

  18. Application of Regent mechanical valve in patients with small aortic annulus: 3-year follow-up

    Directory of Open Access Journals (Sweden)

    Zhao Dong

    2012-09-01

    Full Text Available Abstract Background Aortic valve replacement (AVR with a small aortic annulus is always challenging for the cardiac surgeon. In this study, we sought to evaluate the midterm performance of implantation with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent mechanical valve in retrospective consecutive cohort of patients with small aortic annulus (diameter ≤ 19 mm. Methods From January 2008 to April 2011, 40 patients (31 female, mean age = 47.2 ± 5.8 years with small aortic annulus (≤19 mm in diameter underwent aortic valve replacement with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent mechanical valve. Preoperative mean body surface area, New York Heart Association class, and mean aortic annulus were 1.61 ± 0.26 m2, 3.2 ± 0.4, and 18 ± 1.4 mm respectively. Patients were divided into two groups, according to the implantation of 17 mm SJM Regent mechanical valve (group 1, n = 18 or 19 mm SJM Regent valve (group 2, n = 22. All patients underwent echocardiography examination preoperatively and at one year post-operation. Results There were no early deaths in either group. Follow-up time averaged 36 ± 17.6 months. The mean postoperative New York Heart Association class was 1.3 ± 0.6 (p 2/m2 to 69.8 ± 9.3%, 41.4 ± 8.3%, and 0.92 ± 0.10 cm2/m2 respectively (P 2, 46.1 ± 8.5 mmHg to 86.7 ± 18.2 g/m2 , 13.7 ± 5.2 mmHg respectively. In group 2, the LVEF, LVFS and EOAI increased from 45.9% ± 9.7%, 30.7% ± 8.0%, and 0.81 ± 0.09 cm2/m2 to 77.4% ± 9.7%, 44.5% ± 9.6%, and 1.27 ± 0.11 cm2/m2 respectively, while the LVMI, and the aortic transvalvular pressure gradient decreased from 118.3 ± 27.6 g/m2, 44.0 ± 6.7 mmHg to 80.1 ± 19.7 g/m2, 10.8 ± 4.1 mmHg as well. The prevalence of PPM was documented in 2 patients in Group 1. Conclusions Patients with small aortic annulus and body surface

  19. Kind Heart

    Institute of Scientific and Technical Information of China (English)

    王九龙

    2005-01-01

    一天晚上,布朗先生正在街上散步,突然一个人拦住他。Man:打搅您了,请问可以告诉我附近有警察吗?Mr Brown:没有啊。Man:你能很快就找到警察吗?Mr Brown:不能。Man:太感谢了。Mr Brown:怎么?Man:哈哈,快点交出手表和钱,不然宰了你。Mr Brown is walking in the street at night.Sud-denly a man stops him and asks him.Man:Excuse me,can you tell me if there areany police men near here?Mr Brown:No,there aren’t.Man:Can you find a police man quickly from here?Mr Brown:No.I can’t .Man:Thank you very much.Mr Brown:Why?Man:Haha,hand out yourwatch and money quickly,or I’llkill you.Kind Heart!河南省开封市@王九龙

  20. Take heart!

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Recently, ten new semi-automatic defibrillators were installed at various locations around CERN. This is a preventive measure intended to provide cardiac arrest victims with the best possible response. The first responder could be you!   The Director-General has welcomed the initiative of the Medical Service and Fire Brigade for the installation of ten new semi-automatic defibrillators. You have probably seen them on your way to the restaurant, for example:  brand new semi-automatic defibrillators, ready for an emergency. Housed in a white wall-mounted case, the bright red defibrillators are marked with a white heart symbol crossed by a lightning bolt (see photo). The defibrillator is designed so that anyone can use it. “Anyone can use it, you don’t need to be a health professional,” says Dr Reymond from CERN's Medical Service. Together with the CERN Fire Brigade, he is behind the initiative to have these units put in place. And with good reason, as the unit...

  1. Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol.

    Science.gov (United States)

    Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R

    2016-04-01

    The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662

  2. Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol.

    Science.gov (United States)

    Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R

    2016-04-01

    The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662

  3. [The role of nitric oxide and superoxide synthesis in protective mechanism of ecdysterone in the heart mitochondria of rats with streptozotocin-induced diabetes].

    Science.gov (United States)

    Korkach, Iu P; Rudyk, O V; Kotsiuruba, A V; Prysiazhna, O D; Sahach, V F

    2007-01-01

    This study evaluated generation of O2*- and NO in heart mitochondria isolated from 9-week old streptozotocin (STZ)-induced diabetic rats and the effect of ecdysterone treatment on these parameters. Mitochondria isolated from 9-week old placebo-treated rats were used as control. Several parameters were evaluated: O2*- production, the levels of stable NO metabolites nitrate, nitrite and total nitrosothiols, the level of bilirubine (as marker of CO generation), inducible (iNOS) and constitutive (nNOS) mtNOS, NADH- dependent nitrate reductase (NR) and inducible arginase II (AII) activity. We observed that diabetes was accompanied by a significant decrease in nNOS activity, nitrite, total nitrosothiols and bilirubine content while iNOS, NR and AII activity, as well as O2*- generation was increased in heart mitochondria. Ecdysterone treatment normalized the levels of stable NO metabolites, ability to generate superoxide, iNOS and nNOS activity, but not bilirubine level, NR and AII activity. These results suggest that ecdysterone treatment attenuates diabetes-induced mitochondrial alterations protecting against oxidative and nitrosative stresses. Thus, ecdysterone therapy, besides its well known importance in the maintenance of glycemic control, may help to protect against mitochondrial dysfunction associated to several age-related disorders.

  4. The use of mechanical ventilation in acute left heart failure patients%机械通气抢救急性左心衰竭伴呼吸衰竭的临床观察

    Institute of Scientific and Technical Information of China (English)

    林道德

    2008-01-01

    Objective To evaluate the efficacy of mechanical ventilation in acute left heart failure.Methods 32 patients with acute left heart failure,routine treatments unsuccessful,use mechanical ventilation.Observe the change of heart rate,respiration rate,mean artery pressure,blood gas analysis(pH,PaO2,SaO2,PaCO2)and clinical symptoms.Results After mechanical ventilation,the clinical symptoms of 28 patients were improved,4 patients were dead.After one hour mechanical ventilation,respiration rate decreased from(33.6±7.8)/min to(21.3±3.2)/min(P<0.05),heart rate decreased from(117.8±17.5)/min to(86.7±10.5)/min(P<0.05),mean artery pressure decreased from(96.4±5.2)mmHg to(83.9±7.8)mmHg(P<0.05),SaO2 increased from(75.8±8.6)%to(95.6±3.7)%(P<0.01),PaO2 increased from(49.8±8.7)to(85.3±6.1)(P<0.01),pH and PaCO2 have no significant improve.Conclusion Mechanical ventilation is a safe and effective treatment for acute left heart failure patients.%目的 评价机械通气治疗急性左心衰竭的疗效.方法 对32例常规治疗无效的重症急性左心衰竭患者加用机械通气治疗,观察通气前后HR、RR、平均动脉压(MAP)、动脉血气分析指标(pH、PaO2、SaO2、PaCO2)的变化及临床症状的改善情况.结果 机械通气治疗后,32例患者中28例病情好转,4例死亡.通气1 h后RR由(33.6±7.8)次/min 降至(21.3±3.2)次/min(P<0.05),HR由(117.8±17.5)次/min降至(86.7±10.5)次/min(P<0.05),MAP由(96.4±5.2)mm Hg降至(83.9±7.8)mm Hg(P<0.05).通气前及通气后1 h查血气,SaO2由(75.8±8.6)%升高至(95.6±3.7)%(P<0.01),PaO2由(49.8±8.7)mm Hg升高至(85.3±6.1)mm Hg(P<0.01),pH、PaCO2无显著变化.结论 机械通气是治疗急性左心衰竭伴呼吸衰竭安全有效的方法.

  5. What Causes a Heart Attack?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Causes a Heart Attack? Coronary Heart Disease A heart attack happens if ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  6. Who Needs a Heart Transplant?

    Science.gov (United States)

    ... from the NHLBI on Twitter. Who Needs a Heart Transplant? Most patients referred to heart transplant centers have ... for heart failure. Who Is Eligible for a Heart Transplant? The specialists at the heart transplant center will ...

  7. Hypoplastic left heart syndrome (image)

    Science.gov (United States)

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  8. What Causes Heart Disease?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Heart Disease? Research suggests that coronary heart disease (CHD) begins with damage to the lining and ... causing coronary microvascular disease (MVD). Coronary MVD is heart disease that affects the heart's tiny arteries. The cause ...

  9. Heart Disease in Women

    Science.gov (United States)

    ... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... It's the major reason people have heart attacks. Heart diseases that affect women more than men include Coronary ...

  10. Healthy Heart Quizzes

    Science.gov (United States)

    ... 24,2016 Cardiovascular Conditions • Conditions Home • Arrhythmia and Atrial Fibrillation • Cardiac Arrest • Cardiac Rehab • Cardiomyopathy • Cardiovascular Conditions of Childhood • Cholesterol • Congenital Heart Defects • Diabetes • Heart Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  11. Travel and Heart Disease

    Science.gov (United States)

    ... Privacy Policy Cardiovascular Conditions • Conditions Home • Arrhythmia and Atrial Fibrillation • Cardiac Arrest • Cardiac Rehab • Cardiomyopathy • Cardiovascular Conditions of Childhood • Cholesterol • Congenital Heart Defects • Diabetes • Heart Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  12. Heart failure - tests

    Science.gov (United States)

    ... tests, such as coronary angiography. MRI , CT , or PET scans of the heart may be done to check how much heart muscle damage is present. It can also help detect the reason for a patient's heart failure. Stress tests are done to see whether the heart ...

  13. [Heart arrest].

    Science.gov (United States)

    Chiarella, F; Giovannini, E; Bozzano, A; Caristo, G; Delise, P; Fedele, F; Fera, M S; Lavalle, C; Roghi, A; Valagussa, F

    2001-03-01

    Cardiac arrest is one of the leading causes of mortality in industrialized countries and is mainly due to ischemic heart disease. According to ISTAT estimates, approximately 45,000 sudden deaths occur annually in Italy whereas according to the World Health Organization, its incidence is 1 per 1000 persons. The most common cause of cardiac arrest is ventricular fibrillation due to an acute ischemic episode. During acute ischemia the onset of a ventricular tachyarrhythmia is sudden, unpredictable and often irreversible and lethal. Each minute that passes, the probability that the patient survives decreases by 10%. For this reason, the first 10 min are considered to be priceless for an efficacious first aid. The possibility of survival depends on the presence of witnesses, on the heart rhythm and on the resolution of the arrhythmia. In the majority of cases, the latter is possible by means of electrical defibrillation followed by the reestablishment of systolic function. An increase in equipment alone does not suffice for efficacious handling of cardiac arrest occurring outside the hospital premises. Above all, an adequate intervention strategy is required. Ambulance personnel must be well trained and capable of intervening rapidly, possibly within the first 5 min. The key to success lies in the diffusion and proper use of defibrillators. The availability of new generation instruments, the external automatic defibrillators, encourages their widespread use. On the territory, these emergencies are the responsibility of the 118 organization based, according to the characteristics specific to each country, on the regulated coordination between the operative command, the crews and the first-aid means. Strategies for the handling of these emergencies within hospitals have been proposed by the Conference of Bethesda and tend to guarantee an efficacious resuscitation with a maximum latency of 2 min between cardiac arrest and the first electric shock. The diffusion of external

  14. Heart rate variability in isolated rabbit hearts.

    Science.gov (United States)

    Frey, B; Heger, G; Mayer, C; Kiegler, B; Stöhr, H; Steurer, G

    1996-11-01

    The presence of heart rate variability (HRV) in patients with cardiac denervation after heart transplantation raised our interest in HRV of isolated, denervated hearts. Hearts from seven adult white ELCO rabbits were transferred to a perfusion apparatus. All hearts were perfused in the working mode and in the Langendorff mode for 20 minutes each. HRV was analyzed in the frequency domain. A computer simulated test ECG at a constant rate of 2 Hz was used for error estimation of the system. In the isolated, denervated heart, HRV was of random, broadband fluctuations, different from the well-characterized oscillations at specific frequencies in intact animals. Mean NN was 423 +/- 51 ms in the Langendorff mode, 406 +/- 33 ms in the working heart mode, and 500 ms in the test ECG. Total power was 663 +/- 207 ms2, 817 +/- 318 ms2, and 3.7 ms2, respectively. There was no significant difference in any measure of HRV between Langendorff and working heart modes. The data provide evidence for the presence of HRV in isolated, denervated rabbit hearts. Left atrial and ventricular filling, i.e., the working heart mode, did not alter HRV, indicating that left atrial or ventricular stretch did not influence the sinus nodal discharge rate.

  15. The mechanism of endoplasmic reticulum stress (ERS) in ischemic heart disease (IHD)%内质网应激(ERS)在缺血性心脏病(IHD)中的作用机制

    Institute of Scientific and Technical Information of China (English)

    戴肇星

    2012-01-01

    Endoplasmic reticulum stress (ERS) is closely related with the pathogenesis and therapy of ischemic heart disease (IHD). Sine the 21" century,the mechanism of ERS in IHD receive extentive attention from reseach workers in the world. This article briefly introduces the research history of ERS and IHD,and focus on the research progress in the following three aspects:the signal pathway of ERS activation,the signal pathway of ERS's protective effects on cells within ERS response (ERSR),and the signal pathway of ERS's injury effects on cells beyond the ERSR. Based on these,4 considerations on the treatment of ischemic heart disease are proposed.%内质网应激(endoplasmic reticulum stress,ERS)与缺血性心脏病(ischemic heart disease,IHD)的发生和治疗有着密切的关系.进入21世纪之后,ERS作为IHD的重要机制受到各国学者的广泛关注.本文着重阐述以下三方面的研究进展:ERS激活的信号通路、内质网应激反应(ERS response,ERSR)范围内ERS对细胞保护作用的信号通路及超出ERSR范围后ERS对细胞损伤作用的信号通路,并在此基础上经过分析提出4条治疗IHD的思路.

  16. Mechanisms Involved in the Improvement of Lipotoxicity and Impaired Lipid Metabolism by Dietary α-Linolenic Acid Rich Salvia hispanica L (Salba Seed in the Heart of Dyslipemic Insulin-Resistant Rats

    Directory of Open Access Journals (Sweden)

    Agustina Creus

    2016-01-01

    Full Text Available This study explores the mechanisms underlying the altered lipid metabolism in the heart of dyslipemic insulin-resistant (IR rats fed a sucrose-rich diet (SRD and investigates if chia seeds (rich in α-linolenic acid 18:3, n-3 ALA improve/reverse cardiac lipotoxicity. Wistar rats received an SRD-diet for three months. Half of the animals continued with the SRD up to month 6. The other half was fed an SRD in which the fat source, corn oil (CO, was replaced by chia seeds from month 3 to 6 (SRD+chia. A reference group consumed a control diet (CD all the time. Triglyceride, long-chain acyl CoA (LC ACoA and diacylglycerol (DAG contents, pyruvate dehydrogenase complex (PDHc and muscle-type carnitine palmitoyltransferase 1 (M-CPT1 activities and protein mass levels of M-CPT1, membrane fatty acid transporter (FAT/CD36, peroxisome proliferator activated receptor α (PPARα and uncoupling protein 2 (UCP2 were analyzed. Results show that: (a the hearts of SRD-fed rats display lipotoxicity suggesting impaired myocardial lipid utilization; (b Compared with the SRD group, dietary chia normalizes blood pressure; reverses/improves heart lipotoxicity, glucose oxidation, the increased protein mass level of FAT/CD36, and the impaired insulin stimulated FAT/CD36 translocation to the plasma membrane. The enhanced M-CPT1 activity is markedly reduced without similar changes in protein mass. PPARα slightly decreases, while the UCP2 protein level remains unchanged in all groups. Normalization of dyslipidemia and IR by chia reduces plasma fatty acids (FAs availability, suggesting that a different milieu prevents the robust translocation of FAT/CD36. This could reduce the influx of FAs, decreasing the elevated M-CPT1 activity and lipid storage and improving glucose oxidation in cardiac muscles of SRD-fed rats.

  17. Mechanisms Involved in the Improvement of Lipotoxicity and Impaired Lipid Metabolism by Dietary α-Linolenic Acid Rich Salvia hispanica L (Salba) Seed in the Heart of Dyslipemic Insulin-Resistant Rats.

    Science.gov (United States)

    Creus, Agustina; Ferreira, María R; Oliva, María E; Lombardo, Yolanda B

    2016-01-28

    This study explores the mechanisms underlying the altered lipid metabolism in the heart of dyslipemic insulin-resistant (IR) rats fed a sucrose-rich diet (SRD) and investigates if chia seeds (rich in α-linolenic acid 18:3, n-3 ALA) improve/reverse cardiac lipotoxicity. Wistar rats received an SRD-diet for three months. Half of the animals continued with the SRD up to month 6. The other half was fed an SRD in which the fat source, corn oil (CO), was replaced by chia seeds from month 3 to 6 (SRD+chia). A reference group consumed a control diet (CD) all the time. Triglyceride, long-chain acyl CoA (LC ACoA) and diacylglycerol (DAG) contents, pyruvate dehydrogenase complex (PDHc) and muscle-type carnitine palmitoyltransferase 1 (M-CPT1) activities and protein mass levels of M-CPT1, membrane fatty acid transporter (FAT/CD36), peroxisome proliferator activated receptor α (PPARα) and uncoupling protein 2 (UCP2) were analyzed. Results show that: (a) the hearts of SRD-fed rats display lipotoxicity suggesting impaired myocardial lipid utilization; (b) Compared with the SRD group, dietary chia normalizes blood pressure; reverses/improves heart lipotoxicity, glucose oxidation, the increased protein mass level of FAT/CD36, and the impaired insulin stimulated FAT/CD36 translocation to the plasma membrane. The enhanced M-CPT1 activity is markedly reduced without similar changes in protein mass. PPARα slightly decreases, while the UCP2 protein level remains unchanged in all groups. Normalization of dyslipidemia and IR by chia reduces plasma fatty acids (FAs) availability, suggesting that a different milieu prevents the robust translocation of FAT/CD36. This could reduce the influx of FAs, decreasing the elevated M-CPT1 activity and lipid storage and improving glucose oxidation in cardiac muscles of SRD-fed rats.

  18. How can we cure a heart "in flame"? A translational view on inflammation in heart failure

    OpenAIRE

    Hofmann, Ulrich; Frantz, Stefan

    2016-01-01

    The prevalence of chronic heart failure is still increasing making it a major health issue in the 21st century. Tremendous evidence has emerged over the past decades that heart failure is associated with a wide array of mechanisms subsumed under the term "inflammation". Based on the great success of immuno-suppressive treatments in auto-immunity and transplantation, clinical trials were launched targeting inflammatory mediators in patients with chronic heart failure. However, they widely lack...

  19. A method for accurate, non-destructive diagnosis of congenital heart defects from heart specimens

    OpenAIRE

    Schleich, Jean-Marc; Abdulla, Tariq; Houyel, Lucile; Paul, Jean-François; Summers, Ron; Dillenseger, Jean-Louis

    2013-01-01

    International audience The accurate analysis of congenital heart defect (CHD) specimens is often difficult and up to now required the opening of the heart. The objective of this study is to define a non-destructive method that allows for the precise analysis of each specimen and its different cardiac components in order to improve classification of the defect and thus provide an indication of underpinning causal mechanisms. We propose a method in which the heart volume is acquired by a CT ...

  20. Mechanics

    CERN Document Server

    Hartog, J P Den

    1961-01-01

    First published over 40 years ago, this work has achieved the status of a classic among introductory texts on mechanics. Den Hartog is known for his lively, discursive and often witty presentations of all the fundamental material of both statics and dynamics (and considerable more advanced material) in new, original ways that provide students with insights into mechanical relationships that other books do not always succeed in conveying. On the other hand, the work is so replete with engineering applications and actual design problems that it is as valuable as a reference to the practicing e

  1. Mechanisms and application of mesenchymal stem cells in ischemic heart disease%骨髓间充质干细胞在缺血性心脏病中的作用机制及其应用

    Institute of Scientific and Technical Information of China (English)

    李林岭

    2011-01-01

    缺血性心脏病是一类严重危害人类健康的疾病.在积极开展各种药物和介入治疗的同时,细胞疗法已成为当下心血管领域的一大热点,骨髓间充质干细胞通过移植或骨髓动员至缺血心脏后能有效改善急性心肌梗死患者短期的心功能.本文就骨髓间充质干细胞疗法在缺血性心脏病中的作用机制及其应用的最新研究成果作一综述.%Ischemic heart disease is a great threat to human health. Besides the drugs and interventional therapy, cell therapy has been becoming a hot topic in cardiovascular field. Bone marrow mesenchymal stem cells (MSCs) could improve the short-term cardiac function of patients with acute myocardial infarction when MSCs were transplanted or mobilized into the ischemic myocardium. This review summarized the latest advances in the mechanisms and application of MSCs in ischemic heart disease.

  2. Mitochondria and the aging heart

    Institute of Scientific and Technical Information of China (English)

    Ketul R Chaudhary; Haitham El-Sikhry; John M Seubert

    2011-01-01

    The average human life span has markedly increased in modern society largely attributed to advances in medical and therapeutic sciences that have successfully reduced important health risks.However,advanced age results in numerous alterations to cellular and subcellular components that can impact the overall health and function of an individual.Not surprisingly,advanced age is a major risk factor for the development of heart disease in which elderly populations observe increased morbidity and mortality.Even healthy individuals that appear to have normal heart fimction under resting conditions,actually have an increased susceptibility and vulnerability to stress.This is confounded by the impact that stress and disease can have over time to both the heart and vessels. Although, there is a rapidly growing body of literature investigating the effects of aging on the heart and how age-related alterations affect cardiac fimction, the biology of aging and underlying mechanisms remain unclear .In this review,we summarize effects of aging on the heart and discuss potential theories of cellular aging with special emphasis on mitochondrial dysfunction.

  3. P2X4 receptor–eNOS signaling pathway in cardiac myocytes as a novel protective mechanism in heart failure

    Directory of Open Access Journals (Sweden)

    Ronghua Yang

    2015-01-01

    Full Text Available We have demonstrated using immunoprecipitation and immunostaining a novel physical association of the P2X4 receptor (P2X4R, a ligand-gated ion channel, with the cardioprotective, calcium-dependent enzyme endothelial nitric oxide synthase (eNOS. Treatment of murine ventricular myocytes with the P2XR agonist 2-methylthioATP (2-meSATP to induce a current (mainly Na+ increased the formation of nitric oxide (NO, as measured using a fluorescent probe. Possible candidates for downstream effectors mediating eNOS activity include cyclic GMP and PKG or cellular protein nitrosylation. A cardiac-specific P2X4R overexpressing mouse line was protected from heart failure (HF with improved cardiac function and survival in post-infarct, pressure overload, and calsequestrin (CSQ overexpression models of HF. Although the role of the P2X4R in other tissues such as the endothelium and monocytes awaits characterization in tissue-specific KO, cardiac-specific activation of eNOS may be more cardioprotective than an increased activity of global systemic eNOS. The intra-myocyte formation of NO may be more advantageous over NO derived externally from a donor. A small molecule drug stimulating this sarcolemmal pathway or gene therapy-mediated overexpression of the P2X4R in cardiac myocytes may represent a new therapy for both ischemic and pressure overloaded HF.

  4. P2X4 receptor–eNOS signaling pathway in cardiac myocytes as a novel protective mechanism in heart failure

    Science.gov (United States)

    Yang, Ronghua; Beqiri, Dardan; Shen, Jian-Bing; Redden, John M.; Dodge-Kafka, Kimberly; Jacobson, Kenneth A.; Liang, Bruce T.

    2014-01-01

    We have demonstrated using immunoprecipitation and immunostaining a novel physical association of the P2X4 receptor (P2X4R), a ligand-gated ion channel, with the cardioprotective, calcium-dependent enzyme endothelial nitric oxide synthase (eNOS). Treatment of murine ventricular myocytes with the P2XR agonist 2-methylthioATP (2-meSATP) to induce a current (mainly Na+) increased the formation of nitric oxide (NO), as measured using a fluorescent probe. Possible candidates for downstream effectors mediating eNOS activity include cyclic GMP and PKG or cellular protein nitrosylation. A cardiac-specific P2X4R overexpressing mouse line was protected from heart failure (HF) with improved cardiac function and survival in post-infarct, pressure overload, and calsequestrin (CSQ) overexpression models of HF. Although the role of the P2X4R in other tissues such as the endothelium and monocytes awaits characterization in tissue-specific KO, cardiac-specific activation of eNOS may be more cardioprotective than an increased activity of global systemic eNOS. The intra-myocyte formation of NO may be more advantageous over NO derived externally from a donor. A small molecule drug stimulating this sarcolemmal pathway or gene therapy-mediated overexpression of the P2X4R in cardiac myocytes may represent a new therapy for both ischemic and pressure overloaded HF. PMID:25750695

  5. Comparison between Prothrombin Complex Concentrate (PCC) and Fresh Frozen Plasma (FFP) for the Urgent Reversal of Warfarin in Patients with Mechanical Heart Valves in a Tertiary Care Cardiac Center.

    Science.gov (United States)

    Fariborz Farsad, Bahram; Golpira, Reza; Najafi, Hamideh; Totonchi, Ziae; Salajegheh, Shirin; Bakhshandeh, Hooman; Hashemian, Farshad

    2015-01-01

    Fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC) reverse oral anticoagulants such as Warfarin. We compared the standard dosage of FFP and PCC in terms of efficacy and safety for patients with mechanical heart valves undergoing interventional procedures while receiving Warfarin. Fifty patients were randomized (25 for each group) with mechanical heart valves [international normalized ratio (INR) >2.5]. FFP dosage was administered based on body weight (10-15 mL/Kg), while PCC dosage was administered based on both body weight and target INR. INR measurements were obtained at different time after PCC and FFP infusion. The mean ± SD of INR pre treatment was not significantly different between the PCC and FFP groups. However, over a 48-hour period following the administration of PCC and FFP, 76% of the patients in the PCC group and only 20% of the patients in the FFP group reached the INR target. Five (20%) patients in the PCC group received an additional dose of PCC, whereas 17 (68%) patients in the FFP group received a further dose of FFP (P=0.001). There was no significant difference between the two groups in Hb and Hct before and during a 48-hour period after PCC and FFP infusion. As regards safety monitoring and adverse drug reaction screening in the FFP group, the INR was high (INR > 2.5) in 86% of the patients. There was no report of hemorrhage in both groups. PCC reverses anticoagulation both effectively and safely while having the advantage of obviating the need to extra doses.

  6. Smoking Thickens Heart Wall, Leading to Heart Failure: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160932.html Smoking Thickens Heart Wall, Leading to Heart Failure: Study ... 13, 2016 TUESDAY, Sept. 13, 2016 (HealthDay News) -- Smoking leads to heart failure by causing thickened heart ...

  7. Open heart surgery

    Science.gov (United States)

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  8. Heart Attack Payment - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

  9. Heart Attack Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

  10. Aspirin and heart disease

    Science.gov (United States)

    ... the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology ... NE, et al. Antithrombotic and thrombolytic therapy for ischemic ... of coronary heart disease. In: Mann DL, Zipes DP, Libby P, et ...

  11. Heart disease and women

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007188.htm Heart disease and women To use the sharing features on ... please enable JavaScript. People often do not consider heart disease a woman's disease. Yet cardiovascular disease is the ...

  12. Heart disease - risk factors

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000106.htm Heart disease - risk factors To use the sharing features on ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. Changing ...

  13. Stress and Heart Health

    Science.gov (United States)

    ... Recognition & Awards Healthy Workplace Food and Beverage Toolkit Stress and Heart Health Updated:Jun 13,2014 When ... Health and Heart Health Last reviewed 6/2014 Stress Management • Home • How Does Stress Affect You? Introduction ...

  14. Anatomy of the Heart

    Science.gov (United States)

    ... of your heart are called ventricles. The ventricles pump blood out of your heart to other parts of ... pumped into the left ventricle. The left ventricle pumps the blood to the rest of your body through the ...

  15. Getting a New Heart

    Science.gov (United States)

    ... is in place, the donor's main arteries—the aorta and pulmonary arteries—are sewn to yours. o ... heart and cause strokes and heart attacks. 4. Diabetes Mellitus Anti-rejection medications can cause diabetes. If ...

  16. Heart failure - medicines

    Science.gov (United States)

    ... with which your heart muscle contracts in the short term. Long term beta blockers help keep your heart failure from becoming worse. Over time they may also help strengthen your ... include lightheadedness, depression, fatigue, and memory loss.

  17. Pericarditis - after heart attack

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000166.htm Pericarditis - after heart attack To use the sharing features on this page, ... occur in the days or weeks following a heart attack. Causes Two types of pericarditis can occur after ...

  18. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... second day and can sometimes be managed with acetaminophen (Tylenol). Many children behave differently after heart surgery. ... Tiredness all the time Bluish or grayish skin Dizziness, fainting, or heart palpitations Feeding problems or reduced ...

  19. Right heart ventriculography

    Science.gov (United States)

    Angiography - right heart ... The catheter will be moved forward into the right side of the heart. As the catheter is advanced, the doctor can record pressures from the right atrium and right ventricle. Contrast material ("dye") is ...

  20. Sleep Troubles, Heart Troubles?

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161037.html Sleep Troubles, Heart Troubles? American Heart Association says it's ... 19, 2016 MONDAY, Sept. 19, 2016 (HealthDay News) -- Sleep disorders -- including too little or too much sleep -- ...

  1. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  2. The Utility of Ambulatory Electrocardiographic Monitoring for Detecting Silent Arrhythmias and Clarifying Symptom Mechanism in an Elderly Urban Population with Heart Failure and Hypertension: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Kathleen T. Hickey

    2010-06-01

    Full Text Available Background : Atrial and ventriclar tachyarrhythmias, as well as bradyarrhythmias, in the elderly with heart failure (HF and/or hypertension (HTN have been well documented. However, the frequency of these arrhythmias, whether silent or symptomatic, and their association with subsequent cardiac events has not been well defi ned in patients 65 years or older with HF and other cardiovascular risk factors. Objective : To assess the value of 2 weeks of remote, transtelephonic cardiac monitoring for detecting arrhythmias in an elderly, urban population living with HF. Methods : Fi” y-four patients with a history of systolic HF and/or HTN were consented and enrolled. All wore an auto triggered cardiac loop monitor for 2 weeks that captures EKG data and both silent and symptomatic arrhythmias were recorded. Results : Mean age was 73 ± 6 years with 59% of subjects were females, 74% Hispanic, 22% black, and 4% white/other. All patients had HF and 94% had HTN. From the cardiac monitoring, 72% demonstrated ectopic atrial and ventricular activity, and 1 paroxysmal episode of atrial fi brillation was documented. In addition, 3 subjects had signifi cant non-sustained ventricular tachycardia, and 4 individuals had severe bradycardia recorded on cardiac monitoring. These 7 individuals underwent placement of an implantable cardioverter defi brillator (ICD or pacemaker based on the documented arrhythmias which may have otherwise gone undetected. Conclusions : TA substantial proportion of patients exhibited cardiac arrhythmias. Future morbidity was prevented because of the detection of arrhythmias on monitoring that led to specifi c therapies such as pacemaker or ICD implantation which otherwise may not have been implemented.

  3. Swan-Ganz - right heart catheterization

    Science.gov (United States)

    ... have: Abnormal pressures in the heart arteries Burns Congenital heart disease Heart failure Kidney disease Leaky heart valves (valvular ... 2011:chap 55. Read More Burns Cardiac tamponade Congenital heart disease Heart attack Heart failure - overview Pulmonary hypertension Restrictive ...

  4. Heart Disease in Women

    Science.gov (United States)

    ... States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... the heart itself. This is called coronary artery disease, and it happens slowly over time. It's the ...

  5. Women and Heart Disease

    Institute of Scientific and Technical Information of China (English)

    邹国如

    2005-01-01

    Heart disease is the leading killer of Americans. But it kills more women than men. The American Heart Association says heart disease and other cardiovascular (心血管的) disorders kill about five hundred thousand women a year. That is more than the next seven causes of death combined.

  6. Menopause and Heart Disease

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Menopause and Heart Disease Updated:Apr 18,2016 Heart disease risk rises for everyone as they age, but ... women is seen about 10 years after menopause. Heart disease is the leading killer of women . Estrogen Levels ...

  7. Living with Heart Disease

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Disease If you have coronary heart disease (CHD), you can take steps to control its ... the section of this article titled "How Is Heart Disease Treated?" You also can visit the Health Topics ...

  8. Heart Disease in Women

    Science.gov (United States)

    ... heart disease risk factors causes coronary MVD. Although death rates from heart disease have dropped in the last 30 years, they ... stopped her "dead in her tracks." Jennifer reminds us how heart disease takes too many of our moms, sisters, and ...

  9. Heart disease and depression

    Science.gov (United States)

    Heart disease and depression often go hand-in-hand. You are are more likely to feel sad or depressed after a heart attack ... heart disease. The good news is that treating depression may help improve both your mental and physical ...

  10. Heart Disease Risk Factors

    Science.gov (United States)

    ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke Heart Disease Risk Factors Recommend ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke File Formats Help: How do ...

  11. Heart Valve Diseases

    Science.gov (United States)

    Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

  12. The Heart of Coaching

    Science.gov (United States)

    Docheff, Dennis M.; Gerdes, Dan

    2015-01-01

    This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…

  13. Panic Attack or Heart Attack?

    Science.gov (United States)

    Panic Attack or Heart Attack? Diagnosing heart disease in women A Healthy Hearts Guide ® Heart disease in women is often mistaken for panic attack with shortness of breath, anxiety, palpitations and indigestion. ...

  14. What Is a Heart Attack?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is a Heart Attack? Español A heart attack happens when the flow ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  15. Life After a Heart Attack

    Science.gov (United States)

    ... from the NHLBI on Twitter. Life After a Heart Attack Many people survive heart attacks and live active, ... a few weeks. Anxiety and Depression After a Heart Attack After a heart attack, many people worry about ...

  16. Women and Heart Health Awareness

    Science.gov (United States)

    ... dizziness, loss of balance or coordination, loss of consciousness, or sudden and severe headache. Healthy Hearts Heart ... Health History Healthy Weight Heart Attack The Heart Truth High Blood Pressure High Cholesterol: Understanding Your Risks ...

  17. What Is a Heart Transplant?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is a Heart Transplant? A heart transplant is surgery to remove a ... return to work for many different reasons. The Heart Transplant Process The heart transplant process starts when doctors ...

  18. Congenital heart defect corrective surgeries

    Science.gov (United States)

    ... open Arrhythmias Atrial septal defect (ASD) Breathing difficulty Cardiac catheterization Cardiovascular Coarctation of the aorta Congenital heart disease Heart failure - overview Heart transplant Hypoplastic left heart syndrome Patent ductus arteriosus Pediatric ...

  19. Mechanical circulatory support in treatment of children with refractory heart failure%辅助循环在婴幼儿难治性心力衰竭治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    史珍英; 周燕萍; 徐卓明; 蔡及明; 朱丽敏; 李志浩; 傅惟定

    2011-01-01

    Objective To summarize the intensive care experience of extracorporeal membrane oxygenation (ECMO) and left ventricular assist device ( LYAD) in children with refractory heart failure. Methods Thirteen children having undergone operation for complicated congenital heart disease and I child with fulminant myocarditis received mechanical circulatory support due to refractory heart failure. There were 8 children in ECMO group and 6 children in LVAD group. The mean arterial pressure, central venous pressure, pressure of right atrium, pressure of left atrium, serum lactate concentration and oxygen saturation of mixed venous blood were monitored during mechanical circulatory support. The dosage of inotropic medicine was adjusted, the activated coagulation time was maintained between 150 s and 180 s, hematocrit between 30% and 35%, and platelet count >80 000/mm3. The mechanical circulatory support was weaned off when blood pressure was stable, pulse pressure was no lower than 20 mmHg, and left ventricular ejection fraction reached 50%. Results The mean time of mechanical circulatory support was (147 ± 152) h in ECMO group and LVAD group. During the mechanical circulatory support, the blood pressure increased from (48. 1 ±5.2) mmHg to (60.2 ±7. 8) mmHg (P <0. 05), while the serum lactate concentration decreased from (5. 1 ±0. 8) tnmol/L to (3.6 ±0.5) mraol/L (P <0.05). The survival rate of weaning off was 57. 1% (8/14), and the survival rate of hospital discharge was 42. 9% (6/14). The major complication was severe bleeding in thoracic and abdominal cavity (63.7%). Four children had indifferent mind (23.6%), and 8 had multiple organ dysfunction (57.1 %). During the follow up of 4 to 26 months, the left ventricular ejection fraction was no less than 50%, the cardiac function was class II, the growth of children was significantly improved, and mild to moderate neural sequela was found in 2 children- Conclusion Mechanical circulatory support plays an effective role in

  20. The mitochondrial uniporter controls fight or flight heart rate increases.

    Science.gov (United States)

    Wu, Yuejin; Rasmussen, Tyler P; Koval, Olha M; Joiner, Mei-Ling A; Hall, Duane D; Chen, Biyi; Luczak, Elizabeth D; Wang, Qiongling; Rokita, Adam G; Wehrens, Xander H T; Song, Long-Sheng; Anderson, Mark E

    2015-01-20

    Heart rate increases are a fundamental adaptation to physiological stress, while inappropriate heart rate increases are resistant to current therapies. However, the metabolic mechanisms driving heart rate acceleration in cardiac pacemaker cells remain incompletely understood. The mitochondrial calcium uniporter (MCU) facilitates calcium entry into the mitochondrial matrix to stimulate metabolism. We developed mice with myocardial MCU inhibition by transgenic expression of a dominant-negative (DN) MCU. Here, we show that DN-MCU mice had normal resting heart rates but were incapable of physiological fight or flight heart rate acceleration. We found that MCU function was essential for rapidly increasing mitochondrial calcium in pacemaker cells and that MCU-enhanced oxidative phoshorylation was required to accelerate reloading of an intracellular calcium compartment before each heartbeat. Our findings show that MCU is necessary for complete physiological heart rate acceleration and suggest that MCU inhibition could reduce inappropriate heart rate increases without affecting resting heart rate.

  1. Elevated heart rate and nondipping heart rate as potential targets for melatonin: a review.

    Science.gov (United States)

    Simko, Fedor; Baka, Tomas; Paulis, Ludovit; Reiter, Russel J

    2016-09-01

    Elevated heart rate is a risk factor for cardiovascular and all-cause mortalities in the general population and various cardiovascular pathologies. Insufficient heart rate decline during the night, that is, nondipping heart rate, also increases cardiovascular risk. Abnormal heart rate reflects an autonomic nervous system imbalance in terms of relative dominance of sympathetic tone. There are only a few prospective studies concerning the effect of heart rate reduction in coronary heart disease and heart failure. In hypertensive patients, retrospective analyses show no additional benefit of slowing down the heart rate by beta-blockade to blood pressure reduction. Melatonin, a secretory product of the pineal gland, has several attributes, which predict melatonin to be a promising candidate in the struggle against elevated heart rate and its consequences in the hypertensive population. First, melatonin production depends on the sympathetic stimulation of the pineal gland. On the other hand, melatonin inhibits the sympathetic system in several ways representing potentially the counter-regulatory mechanism to normalize excessive sympathetic drive. Second, administration of melatonin reduces heart rate in animals and humans. Third, the chronobiological action of melatonin may normalize the insufficient nocturnal decline of heart rate. Moreover, melatonin reduces the development of endothelial dysfunction and atherosclerosis, which are considered a crucial pathophysiological disorder of increased heart rate and pulsatile blood flow. The antihypertensive and antiremodeling action of melatonin along with its beneficial effects on lipid profile and insulin resistance may be of additional benefit. A clinical trial investigating melatonin actions in hypertensive patients with increased heart rate is warranted. PMID:27264986

  2. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention.

    Science.gov (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-05-19

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  3. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention).

    Science.gov (United States)

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-06-01

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  4. Curved butterfly bileaflet prosthetic cardiac valve

    Science.gov (United States)

    McQueen, David M.; Peskin, Charles S.

    1991-06-25

    An annular valve body having a central passageway for the flow of blood therethrough with two curved leaflets each of which is pivotally supported on an accentric positioned axis in the central passageway for moving between a closed position and an open position. The leaflets are curved in a plane normal to the eccentric axis and positioned with the convex side of the leaflets facing each other when the leaflets are in the open position. Various parameters such as the curvature of the leaflets, the location of the eccentric axis, and the maximum opening angle of the leaflets are optimized according to the following performance criteria: maximize the minimum peak velocity through the valve, maximize the net stroke volume, and minimize the mean forward pressure difference, thereby reducing thrombosis and improving the hemodynamic performance.

  5. Focus on renal congestion in heart failure.

    Science.gov (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  6. Gene expression analysis of zebrafish heart regeneration.

    Directory of Open Access Journals (Sweden)

    Ching-Ling Lien

    2006-08-01

    Full Text Available Mammalian hearts cannot regenerate. In contrast, zebrafish hearts regenerate even when up to 20% of the ventricle is amputated. The mechanism of zebrafish heart regeneration is not understood. To systematically characterize this process at the molecular level, we generated transcriptional profiles of zebrafish cardiac regeneration by microarray analyses. Distinct gene clusters were identified based on temporal expression patterns. Genes coding for wound response/inflammatory factors, secreted molecules, and matrix metalloproteinases are expressed in regenerating heart in sequential patterns. Comparisons of gene expression profiles between heart and fin regeneration revealed a set of regeneration core molecules as well as tissue-specific factors. The expression patterns of several secreted molecules around the wound suggest that they play important roles in heart regeneration. We found that both platelet-derived growth factor-a and -b (pdgf-a and pdgf-b are upregulated in regenerating zebrafish hearts. PDGF-B homodimers induce DNA synthesis in adult zebrafish cardiomyocytes. In addition, we demonstrate that a chemical inhibitor of PDGF receptor decreases DNA synthesis of cardiomyocytes both in vitro and in vivo during regeneration. Our data indicate that zebrafish heart regeneration is associated with sequentially upregulated wound healing genes and growth factors and suggest that PDGF signaling is required.

  7. Heart Age PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-09-01

    This 60 second public service announcement is based on the September 2015 CDC Vital Signs report. Your heart age is the age of your heart and blood vessels as a result of your risk factors for heart attack and stroke. If you smoke or have high blood pressure, your heart age will be much higher than your actual age. Learn what you can do to lower your heart age and keep it low.  Created: 9/1/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/1/2015.

  8. Mechanics

    CERN Document Server

    Chester, W

    1979-01-01

    When I began to write this book, I originally had in mind the needs of university students in their first year. May aim was to keep the mathematics simple. No advanced techniques are used and there are no complicated applications. The emphasis is on an understanding of the basic ideas and problems which require expertise but do not contribute to this understanding are not discussed. How­ ever, the presentation is more sophisticated than might be considered appropri­ ate for someone with no previous knowledge of the subject so that, although it is developed from the beginning, some previous acquaintance with the elements of the subject would be an advantage. In addition, some familiarity with element­ ary calculus is assumed but not with the elementary theory of differential equations, although knowledge of the latter would again be an advantage. It is my opinion that mechanics is best introduced through the motion of a particle, with rigid body problems left until the subject is more fully developed. Howev...

  9. After Heart Attack, New Threat: Heart Failure

    Science.gov (United States)

    ... poorest patients had a 27 percent increased risk. Atrial fibrillation -- a condition characterized by an abnormal heartbeat -- and diabetes also significantly increased the risk of heart failure, by 63 percent and 44 percent, respectively. Other ...

  10. Atrial Fibrillation in Congestive Heart Failure

    OpenAIRE

    Lubitz, Steven A.; Benjamin, Emelia J.; Ellinor, Patrick T.

    2010-01-01

    Atrial fibrillation and congestive heart failure are morbid conditions that share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two identifies individuals at increased risk for mortality. Recent data have emerged which help elucidate the complex genetic and non-genetic pathophysiological mechanisms that contribute to the development of atrial fibrillation in individuals with congestive heart failure. Clinical trial res...

  11. Modulating fatty acid oxidation in heart failure

    OpenAIRE

    Lionetti, Vincenzo; Stanley, William C.; Recchia, Fabio A.

    2011-01-01

    In the advanced stages of heart failure, many key enzymes involved in myocardial energy substrate metabolism display various degrees of down-regulation. The net effect of the altered metabolic phenotype consists of reduced cardiac fatty oxidation, increased glycolysis and glucose oxidation, and rigidity of the metabolic response to changes in workload. Is this metabolic shift an adaptive mechanism that protects the heart or a maladaptive process that accelerates structural and functional dera...

  12. 机械心脏瓣膜术后患者自我管理行为的研究%Research for self- management action of patient suffered from mechanical heart valve post-operation

    Institute of Scientific and Technical Information of China (English)

    李飞霞; 袁述兰; 梁克

    2011-01-01

    目的 探讨机械心脏瓣膜术后患者行为的自我管理.方法 将168例机械心脏瓣膜术后患者随机分为干预组86例和对照组82例.干预组患者在常规药物治疗的同时给予有针对性的自我管理教育,而对照组患者在常规药物治疗的同时则行常规健康教育,分别于治疗护理1年后采用"自我管理行为量表"对两组患者进行测定,评估两组患者的自我管理行为,并应用中文版SF-36量表对两组患者进行评价,比较两组患者的生活质量(QOL).结果 治疗护理1年后,干预组患者的自我管理行为量表及SF-36量表的各项评分均明显高于对照组,两组比较差异均有统计学意义(P<0.01).结论 自我管理教育可帮助患者建立良好的健康行为模式,能提高患者自我管理疾病的能力,减少并发症的发生,从而促进康复,达到提高机械心脏瓣膜术后患者生活质量的目的.%Objective To explore the self-management action of patient suffered from mechanical heart valve post-operation. Methods 168cases of the patients suffered from the mechanical heart valve post-operation were separately divided into 86 cases as the interference group and 82 cases as control group at random. The interference group was given for the normal medical treatment and also objective self-management education but the control group used normal medical treatment and also health education. Two groups of the patients were tested by "Self-Management Action Measurement Form" separately to asseSS the self-management action and also were assessed by Chinese version of SF-36 Measurement Form for the assessment of two groups of the patients for the comparison of the patients of two groups in living quality(QOL) one year after treatment and nursing. Results The various items of assessments of interference group were higher than the comparison group in self-management action measurement form SF-36 Measurement Form with the difference of statistics meaning

  13. Mechanisms, diagnoses and therapies of heart failure with preserved ejection fraction%慢性射血分数保留心力衰竭的发病机制与诊治

    Institute of Scientific and Technical Information of China (English)

    赵鹏; 李玉明

    2015-01-01

    Heart failure with left ventricular ejection fraction is not common, which is named HF with preserved EF (HF-pEF), is increasingly predominant form of HF in the real world. Its morbidity and mortality are equal with HF with reduced EF (HF-rEF) and it remains the most challenging of clinical syndromes for the practicing clinician, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common comorbidities. As the list of failed treatments continues to grow, HF-pEF clearly represents a major unmet medical need. In this article, we provide an overview of HF-pEF for both the clinical and basic research, which includes a brief examination of its evolving epidemiology, a summary of proposed mechanisms, the diagnostic criteria, a review of our valiant but unsuccessful prior efforts to develop an effective therapy and a discussion of newer potential approaches.%左心室射血分数保留的心力衰竭(HF-pEF)在临床中较常见,处理此类心力衰竭对临床医生是一个挑战。HF-pEF的发病率和死亡率与左心室射血分数降低的心力衰竭(HF-rEF)相同,且发病机制更加复杂,既有心脏本身也有其他脏器的异常,同时还存在多种并发症间的相互作用影响。现有治疗心力衰竭的多数药物对于HFpEF无效,因此这类患者应该受到更多的关注。本文基于临床实践和基础研究,总结了HFpEF的流行病学特点、发病机制、诊断标准、医学上曾经尝试过的治疗方法,并对未来治疗本病的新手段进行讨论。

  14. "The Heart Game"

    DEFF Research Database (Denmark)

    Dithmer, Marcus; Rasmussen, Jack Ord; Grönvall, Erik;

    2016-01-01

    OBJECTIVE: The aim of this article is to describe the development and testing of a prototype application ("The Heart Game") using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. MATERIALS AND METHODS: A prototype game was developed via...... (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. RESULTS: The heart patients reported the application to be a useful...... activities. CONCLUSIONS: "The Heart Game" concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated...

  15. Optical coherence tomography provides an ability to assess mechanical property of cardiac wall of developing outflow tract in embryonic heart in vivo

    Science.gov (United States)

    Li, Peng; Wang, Ruikang K.

    2012-12-01

    Knowledge of the biomechanical/elastic property of the cardiac wall is of fundamental importance in improving our understanding of cardiac development, particularly the interaction between the wall dynamics and hemodynamics in the developing outflow tract (OFT). We describe a method that employs optical coherence tomography (OCT) as a means to noninvasively measure the local elastic property of the cardiac wall in vivo. The method uses a time-lapse sequence of OCT images that represent the dynamic behavior of the OFT longitudinal section to calculate the regional wall pulse wave velocity (PWV), upon which the Young's modulus of the cardiac wall is deduced by the use of the Moens-Korteweg equation. The experimental results show that the foot-to-foot PWV ranges from 3.2 to 6.6 mm/s with a mean of 4.7 mm/s, and the averaged Young's modulus is 0.36 Pa, both of which are comparable to the documented values of stage HH17 atrioventricular canal tissue. The proposed method that provides the quantitative mechanical assessment may play a significant role in the understanding of the cardiac development.

  16. Adult congenital heart disease

    OpenAIRE

    Morphet, John AM

    2006-01-01

    One million people over the age of 20 suffer from congenital heart disease in the United States. These adult patients can slip through the cracks of our medical system; many are too old to be cared for in most pediatric institutions by pediatric cardiologists and, unfortunately, most adult cardiologists are not trained in congenital heart disease. Therefore, it is important to identify the common lesions in adult congenital heart disease and how they should be managed. Acyanotic congenital he...

  17. Antithrombotics in heart failure.

    OpenAIRE

    Miličić, Davor; Samardžić, Jure; Petričević, Mate

    2014-01-01

    Heart failure is a common clinical condition associated with high morbidity and mortality rate despite significant improvements in pharmacotherapy and implementation of medical procedures. Patients with heart failure are at an increased risk of developing arterial and venous thrombosis, which contribute to the high rate of adverse events and fatal outcomes. Many heart failure patients routinely receive antithrombotic therapy due to the presence of a specific indication...

  18. Nonlinear Time Domain Relation between Respiratory Phase and Timing of the First Heart Sound

    OpenAIRE

    Hong Tang; Yongwan Park; Chengjie Ruan

    2015-01-01

    The previous studies on respiratory physiology have indicated that inspiration and expiration have opposite effects on heart hemodynamics. The basic reason why these opposite hemodynamic changes cause regular timing variations in heart sounds is the heart sound generation mechanism that the acoustic vibration is triggered by heart hemodynamics. It is observed that the timing of the first heart sound has nonlinear relation with respiratory phase; that is, the timing delay with respect to the R...

  19. Role of Strain Imaging in Right Heart Disease: A Comprehensive Review

    OpenAIRE

    Kannan, Arun; Poongkunran, Chithra; Jayaraj, Mahendran; Janardhanan, Rajesh

    2014-01-01

    Advances in the imaging techniques of the heart have fueled the interest in understanding of right heart pathology. Recently, speckle tracking echocardiography has shown to aid in understanding various right heart diseases and better management. Its role is well established in diagnosing right heart failure, pulmonary artery hypertension, arrhythmogenic right ventricular dysplasia and congenital heart disease. We review the basic mechanics of speckle tracking and analyze its role in various r...

  20. What Is a Total Artificial Heart?

    Science.gov (United States)

    ... Trials Links Related Topics Heart Failure Heart Surgery Heart Transplant How the Heart Works Ventilator/Ventilator Support Send ... has become so severe that all treatments, except heart transplant , have failed. (A heart transplant is surgery to ...

  1. Nutrition in Heart Failure

    OpenAIRE

    Reci Meseri

    2013-01-01

    Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilem...

  2. Heart Rhythm Society

    Science.gov (United States)

    ... Certified Education Courses & Online Learning Heart Rhythm On Demand Co-Sponsored & Endorsed Events Educational Resources Career Resources Job Board Fellowships & Program Directors Volunteering IBHRE Exam Jobs ...

  3. Tachycardia | Fast Heart Rate

    Science.gov (United States)

    ... Heart patient sheets Arrhythmia • Home • About Arrhythmia Introduction Atrial Fibrillation Bradycardia Conduction Disorders Premature Contractions Tachycardia Ventricular Fibrillation Other Rhythm Disorders Types of ...

  4. Connection forms for beating the heart

    DEFF Research Database (Denmark)

    Mensch, Arthur; Piuze, Emmanuel; Lehnert, Lucas;

    2014-01-01

    We combine recent work on modeling cardiac mechanics using a finite volume method with the insight that heart wall myofiber orientations exhibit a particular volumetric geometry. In our finite vol- ume mechanical simulation we use Maurer-Cartan one-forms to add a geometrical consistency term...... to control the rate at which myofiber ori- entation changes in the direction perpendicular to the heart wall. This allows us to estimate material properties related to both the passive and active parameters in our model. We have obtained preliminary results on the 4 canine datasets of the 2014 mechanics...... challenge using the FEBio software suite. In ongoing work we are validating and improving the model using rat heart (ex-vivo DTI and in-vivo tagging) MRI datasets, from which we have estimated strain tensors....

  5. Pediatric cardiology. Clinical and practical experiences with heart diseases of children, juveniles and young adults; Kinderkardiologie. Klinik und Praxis der Herzerkrankungen bei Kindern, Jugendlichen und jungen Erwachsenen

    Energy Technology Data Exchange (ETDEWEB)

    Haas, Nikolaus A. [Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany). Klinik fuer angeborene Herzfehler; Kleideiter, Ulrich [Klinik fuer Kinder- und Jugendmedizin, Coesfeld (Germany)

    2011-07-01

    The book on pediatric cardiology covers the following chapters: (I) Fundamentals and diagnostics: pediatric cardiologic anamnesis, electrocardiograms, thorax X-radiography, MRT and CT of the heart, nuclear medical diagnostics, exercise tests, heart catheter examination, electrophysiological tests. (II) Leading symptoms: Cyanosis, cardiac murmur, thorax pain, palpitation, syncopes. (III) Disease pictures: congenital heart defects, acquired heart defects, cardiomyopathies, heart rhythm disturbances, heart insufficiency, arterial hypertension, pulmonary hypertension, other heart involving syndromes. (IV) Therapy: Catheter interventional therapy, post-surgical pediatric cardiac therapy, surgery involving the life-support machine, mechanical cardiovascular support systems, initial treatment of newborns with critical heart defects, heart transplantation, vaccination of children with heart diseases, medicinal therapy.

  6. Therapeutic options in chronic heart failure. Findings on chest X-ray; Nicht medikamentoese Therapieoptionen der chronischen Herzinsuffizienz. Befunde in der Projektionsradiografie des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Granitz, M.R.; Meissnitzer, T.; Meissnitzer, M.W.; Hergan, K.; Altenberger, J.; Granitz, C. [Uniklinikum Salzburg - Landeskrankenhaus (Austria)

    2016-05-15

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  7. Heart Health Tests for Diabetes Patients

    Science.gov (United States)

    ... Heart Defects Symptoms & Diagnosis of Congenital Heart Defects Care & Treatment for Congenital Heart Defects Congenital Heart Defects Tools & Resources Diabetes About Diabetes Why Diabetes Matters Understand Your Risk ...

  8. Medicinal Chemistry Approaches to Heart Regeneration.

    Science.gov (United States)

    Schade, Dennis; Plowright, Alleyn T

    2015-12-24

    Because of the minimal and clearly insufficient ability of the adult heart to regenerate after ischemic injury, there is a great opportunity to identify biological mechanisms, substances, and factors that enhance this process. Hence, innovative therapeutic management of heart failure following infarction requires a paradigm shift in pharmacotherapy. Spurred by tremendous progress in the field of stem cell and cardiac biology, several attractive approaches for regeneration of lost cardiomyocytes and supporting vasculature have emerged. Research in this area focuses on restoring the hearts' original function via proliferation and differentiation of cardiac progenitor cells, proliferation of pre-existing cardiomyocytes, and reprogramming of cardiac fibroblasts. In this review, we outline these principal strategies, putative biological targets or signaling pathways and chemical agents, with a focus on small molecules, to achieve therapeutic heart regeneration. We also point out the many remaining questions and challenges, particularly for translating in vitro discoveries to in vivo application.

  9. Women's Heart Disease: Join the Heart Truth Community

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter ... introduced as the national symbol for women and heart disease awareness in 2002 by the NHLBI. The Red ...

  10. Women and Heart Disease: Sharing Advice from the Heart

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring ... gowns in an effort to raise awareness that heart disease is the leading cause of death among women. ...

  11. Congestive Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sands, Scott A; Owens, Robert L

    2016-03-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation.

  12. Congestive Heart Failure and Central Sleep Apnea.

    Science.gov (United States)

    Sands, Scott A; Owens, Robert L

    2016-03-01

    Congestive heart failure (CHF) is among the most common causes of admission to hospitals in the United States, especially in those over age 65. Few data exist regarding the prevalence CHF of Cheyne-Stokes respiration (CSR) owing to congestive heart failure in the intensive care unit (ICU). Nevertheless, CSR is expected to be highly prevalent among those with CHF. Treatment should focus on the underlying mechanisms by which CHF increases loop gain and promotes unstable breathing. Few data are available to determine prevalence of CSR in the ICU, or how CSR might affect clinical management and weaning from mechanical ventilation. PMID:26972039

  13. Ischaemic heart disease

    DEFF Research Database (Denmark)

    Hansen, Louise Houlberg; Mikkelsen, Søren

    2013-01-01

    Purpose. Correct prehospital diagnosis of ischaemic heart disease (IHD) may accelerate and improve the treatment. We sought to evaluate the accuracy of prehospital diagnoses of ischemic heart diseases assigned by physicians. Methods. The Mobile Emergency Care Unit (MECU) in Odense, Denmark...

  14. World Heart Day

    Centers for Disease Control (CDC) Podcasts

    2009-09-01

    For World Heart Day, learn more about what heart-healthy steps you can take in the workplace.  Created: 9/1/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/9/2009.

  15. Music and the heart.

    Science.gov (United States)

    Koelsch, Stefan; Jäncke, Lutz

    2015-11-21

    Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR increase. Moreover, HR and RR tend to increase in response to music compared with silence, and HR appears to decrease in response to unpleasant music compared with pleasant music. We found no studies that would provide evidence for entrainment of HR to musical beats. Corresponding to the increase in HR, listening to exciting music (compared with tranquilizing music) is associated with a reduction of heart rate variability (HRV), including reductions of both low-frequency and high-frequency power of the HRV. Recent findings also suggest effects of music-evoked emotions on regional activity of the heart, as reflected in electrocardiogram amplitude patterns. In patients with heart disease (similar to other patient groups), music can reduce pain and anxiety, associated with lower HR and lower BP. In general, effects of music on the heart are small, and there is great inhomogeneity among studies with regard to methods, findings, and quality. Therefore, there is urgent need for systematic high-quality research on the effects of music on the heart, and on the beneficial effects of music in clinical settings.

  16. Heart transplant - series (image)

    Science.gov (United States)

    ... The main problem, as with other transplants, is graft rejection. If rejection can be controlled, then survival can ... major problems are the same all major organ transplants face: a shortage of donor hearts rejection of the transplanted heart cost of the surgery ...

  17. Mapping the Heart

    Science.gov (United States)

    Hulse, Grace

    2012-01-01

    In this article, the author describes how her fourth graders made ceramic heart maps. The impetus for this project came from reading "My Map Book" by Sara Fanelli. This book is a collection of quirky, hand-drawn and collaged maps that diagram a child's world. There are maps of her stomach, her day, her family, and her heart, among others. The…

  18. Coronary Heart Disease

    Science.gov (United States)

    ... by Mail Close www.diabetes.org > Living With Diabetes > Treatment and Care > Women Share: Print Page Text Size: A A ... heart-and-circulation, In this section Living With Diabetes Treatment and Care Women Coronary Heart Disease Sexual Health Women and ...

  19. 心房钠尿肽对力竭小鼠心脏的抗氧化作用及其分泌机制%Exhaustive atrial natriuretic peptide on mouse heart antioxidant and secretion mechanism

    Institute of Scientific and Technical Information of China (English)

    李廷武; 徐敬

    2014-01-01

    目的 探讨血浆心房钠尿肽(ANP)在游泳力竭小鼠分泌及其抗氧化作用机制.方法 对小鼠进行分组后,让其负重游泳,并检测小鼠力竭后血浆ANP、丙二醛(MDA)、乳酸(LD)及乳酸脱氢酶(LDH)水平.结果 力竭组小鼠心脏LD为(1.69±0.29) mmol/g蛋白、LDH为(23.69±5.28) U/mg蛋白、ANP为(13.65±1.69)mg/L,显著高于对照组,差异有统计学意义(P<0.05).ANP对双氧水(H2O2)引起的心脏组织损伤具有保护作用,而LY83583阻断剂破坏该种保护作用,从而导致小鼠MDA水平增加,与ANP组比较差异有统计学意义(P<0.05).结论 ANP对心脏具有一定的抗氧化作用,在一定程度上能保护心脏免受损伤,其释放途径主要是通过环磷酸鸟苷(cGMP)-蛋白激酶C(PKC)信号传输途径实现.%Objective To investigate plasma atrial natriuretic peptide (ANP) secretion in mice exhaustive swimming and antioxidant mechanisms.Methods The experimental mice were grouped,let loaded swimming,and after exhaustive tests in mice plasma ANP,malondialdehyde (MDA),lactic acid (LD) and lactate dehydrogenase (LDH) levels.Results The levels of LD (1.69 ± 0.29) mmol/g prot,LDH (23.69 ±5.28) U/mg prot,ANP (13.65 ± 1.69) mg/L of exhausted group mouse heart were significantly higher,the difference was statistically significant (P < 0.05).ANP on hydrogen peroxide (H2O2)-induced cardiac tissue injury has a protective effect,while LY83583 blockers disrupt the kind of protection,resulting in mice LD,LDH and MDA levels increased,compared with the ANP group,the difference was statistically significant (P < 0.05).Conclusion ANP on the heart has some antioxidant effects,to a certain extent,protect the heart from damage,the release pathway mainly through cyclic guanosine monophosphate (cGMP)-protein kinase C (PKC) signaling pathway implementation.

  20. Forkhead box transcription factors in embryonic heart development and congenital heart disease.

    Science.gov (United States)

    Zhu, Hong

    2016-01-01

    Embryonic heart development is a very complicated process regulated precisely by a network composed of many genes and signaling pathways in time and space. Forkhead box (Fox, FOX) proteins are a family of transcription factors characterized by the presence of an evolutionary conserved "forkhead"or "winged-helix" DNA-binding domain and able to organize temporal and spatial gene expression during development. They are involved in a wide variety of cellular processes, such as cell cycle progression, proliferation, differentiation, migration, metabolism and DNA damage response. An abundance of studies in model organisms and systems has established that Foxa2, Foxc1/c2, Foxh1 and Foxm1, Foxos and Foxps are important components of the signaling pathways that instruct cardiogenesis and embryonic heart development, playing paramount roles in heart development. The previous studies also have demonstrated that mutations in some of the forkhead box genes and the aberrant expression of forkhead box gene are heavily implicated in the congenital heart disease (CHD) of humans. This review primarily focuses on the current understanding of heart development regulated by forkhead box transcription factors and molecular genetic mechanisms by which forkhead box factors modulate heart development during embryogenesis and organogenesis. This review also summarizes human CHD related mutations in forkhead box genes as well as the abnormal expression of forkhead box gene, and discusses additional possible regulatory mechanisms of the forkhead box genes during embryonic heart development that warrant further investigation.

  1. Heart Disease and Stroke Prevention

    Science.gov (United States)

    ... disease and stroke prevention Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about ... well-being. Does menopausal hormone therapy (MHT) prevent heart disease? Once you reach menopause, your ovaries stop making ...

  2. Living with Coronary Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

  3. Living with Diabetic Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Diabetic Heart Disease Diabetic heart disease (DHD) increases the likelihood of earlier and more ... also tend to have less success from certain heart disease treatments, such as coronary artery bypass grafting and ...

  4. Heart Disease and African Americans

    Science.gov (United States)

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  5. Signs of a Heart Attack

    Science.gov (United States)

    ... attack Heart Health and Stroke Signs of a heart attack Related information Make the Call. Don't Miss ... to top More information on Signs of a heart attack Read more from womenshealth.gov Make the Call, ...

  6. STUDY ON THE RELATIONSHIP AMONG THE HEART MERIDIAN,CARDIAC REFERRED PAIN AND THE HEART

    Institute of Scientific and Technical Information of China (English)

    RONG Peijing; ZHU Bing

    2002-01-01

    @@ Purpose: The referred pain of the somatic structure, a response of the visceralgia, is often seen in clinic. But its underlying mechanisms are poorly understood. It is interested that cardiac referred pain often appears along the running course of the Heart Meridian (HM), while acupuncture of the acupoints of HM can effectively relieve cardiac pain. In the present study, the neural basis of the relationship among the HM, cardiac referred pain and the heart is investigated by using tri-labeling technique.

  7. Mitochondrial Metabolism in Aging Heart.

    Science.gov (United States)

    Lesnefsky, Edward J; Chen, Qun; Hoppel, Charles L

    2016-05-13

    Altered mitochondrial metabolism is the underlying basis for the increased sensitivity in the aged heart to stress. The aged heart exhibits impaired metabolic flexibility, with a decreased capacity to oxidize fatty acids and enhanced dependence on glucose metabolism. Aging impairs mitochondrial oxidative phosphorylation, with a greater role played by the mitochondria located between the myofibrils, the interfibrillar mitochondria. With aging, there is a decrease in activity of complexes III and IV, which account for the decrease in respiration. Furthermore, aging decreases mitochondrial content among the myofibrils. The end result is that in the interfibrillar area, there is ≈50% decrease in mitochondrial function, affecting all substrates. The defective mitochondria persist in the aged heart, leading to enhanced oxidant production and oxidative injury and the activation of oxidant signaling for cell death. Aging defects in mitochondria represent new therapeutic targets, whether by manipulation of the mitochondrial proteome, modulation of electron transport, activation of biogenesis or mitophagy, or the regulation of mitochondrial fission and fusion. These mechanisms provide new ways to attenuate cardiac disease in elders by preemptive treatment of age-related defects, in contrast to the treatment of disease-induced dysfunction. PMID:27174952

  8. The Effects and Mechanism of C-Type Natriuretic Peptides on Swine Heart Coronary Artery%C型利钠肽扩张猪冠状动脉的作用及机制的研究

    Institute of Scientific and Technical Information of China (English)

    舒燕; 李其勇; 姜荣建; 孔洪

    2015-01-01

    Objective Investigate the influences of C-natriuretic peptides on langendorff-perfused swine heart coronary. Reveal the underlying vasodilatory ability and mechanism of C-natriuretic peptides. Methods Three different groups named the C-Natriuretic Group ( CNP Group) , the Nitroglycerol Group ( GTN Group) , and the NPR-C Receptor Agonist Group ( cANF4-23 Group) were set up.①Each of above groups was perfused by solution of NE,and then was perfused by GTN、CNP and cANF4-23. The vasodilatory influences of CNP and GTN on swine heart coronary arteries and whether cANF4-23 were involved in this procedure were studied .②cANF4-28 was given first, and then CNP were added, the vasodilatory influences were observed.③K + solutions ( at the concentration of 80 nM) were used to preserve the arteries, so they were all in contracted state, and then CNP and cANF4-23 were added, and the vasodilatory influences were observed. Results ①CNP,GTN and cANF4-23 all had significant vasodilatory in-fluences on swine heart coronary artery. no significant difference of vasodilation influences was found between CNP Group and cANF4-23 Group(P>0. 05). The vasodilatory influence of CNP Group was weaker than GTN Group (P<0. 05).②In cANF4-28 preserved arteries, The largest circulus vasculosus vasodilatory ratios of CNP was significantly weaker than Control Group , and had statistical significance (P<0. 01).③The vasodilatory influences of CNP and cANF4-23 Groups were significantly decreased in high concentration K + solution in contrast with the Control Group ( P<0. 05 ) , but not blocked. Conclusions C- Natriuretic peptides have significant vasodilatory influence on swine heart coronary artery. The vasodilatory mechanism of CNP involves NPR-C. NPR-C is not only the well-known clearance receptor, but also leads to vasodilation of the coronary artery. the vasodilatory of CNP/NPR-C sig-naling involves K+ channel.%目的:本研究通过离体灌流方法观察C型利钠肽( CNP)对离体

  9. Angioplasty and stent placement - heart

    Science.gov (United States)

    ... angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation ... to carefully guide the catheter up into your heart and arteries. Dye will be injected into your ...

  10. A healthy heart is not a metronome: an integrative review of the heart's anatomy and heart rate variability.

    Science.gov (United States)

    Shaffer, Fred; McCraty, Rollin; Zerr, Christopher L

    2014-01-01

    Heart rate variability (HRV), the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operate on different time scales to adapt to challenges and achieve optimal performance. This article briefly reviews neural regulation of the heart, and its basic anatomy, the cardiac cycle, and the sinoatrial and atrioventricular pacemakers. The cardiovascular regulation center in the medulla integrates sensory information and input from higher brain centers, and afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. This article reviews sympathetic and parasympathetic influences on the heart, and examines the interpretation of HRV and the association between reduced HRV, risk of disease and mortality, and the loss of regulatory capacity. This article also discusses the intrinsic cardiac nervous system and the heart-brain connection, through which afferent information can influence activity in the subcortical and frontocortical areas, and motor cortex. It also considers new perspectives on the putative underlying physiological mechanisms and properties of the ultra-low-frequency (ULF), very-low-frequency (VLF), low-frequency (LF), and high-frequency (HF) bands. Additionally, it reviews the most common time and frequency domain measurements as well as standardized data collection protocols. In its final section, this article integrates Porges' polyvagal theory, Thayer and colleagues' neurovisceral integration model, Lehrer et al.'s resonance frequency model, and the Institute of HeartMath's coherence model. The authors conclude that a coherent heart is not a metronome because its rhythms are characterized by both complexity and stability over longer time scales. Future research should expand understanding of how the heart and its intrinsic nervous system influence the brain.

  11. Mechanical circulatory treatment of advanced heart failure

    DEFF Research Database (Denmark)

    Rujic, Dragana; Sundbøll, Jens; Tofig, Bawer Jalal;

    2016-01-01

    The paroxysmal supraventricular tachycardias (SVT) are commonly encountered arrhythmias and include atrioventricular nodal re-entrant tachycardia, atrioventricular reciprocating tachycardia, and focal atrial tachycardia. These tachycardias share several clinical features as well as similar manage...

  12. 畅心饮改善冠心病心肌缺血及其机制初步研究%Changxinyin Decoction for Ameliorating Cardiac Ischemia of Coronary Heart Disease and Its Underlying Mechanisms: A Pilot Clinical Study

    Institute of Scientific and Technical Information of China (English)

    郭炜; 崔松; 金涛

    2011-01-01

    Objective To observe the effects of Changxinyin Decoction (a traditional Chinese medicinemainly composed of coptis, pinellia, snakegourd fruit, salvia miltiorrhiza, earthworm, cassia twig, and astragalus) on angina pectoris, traditional Chinese medicine (TCM) syndromes and cardiac ischemia in coronary heart disease patients, and explore its underlying mechanisms. Methods A total of 66 patients with coronary heart disease were divided into 2 groups. Thirty-two patients in the control group were treated with conventional western therapies; additionally, 34 patients in the treatment group were treated with Changxinyin Decoction.The therapeutic effects of Changxinyin Decoction on angina pectoris and TCM syndromes were observed; and its effects on total ischemic burden (TIB) and body mass index (BMI) as well as the levels of high sensitive C-reactive protein (hs-CRP) and blood lipids, including low density lipoprotein-cholesterol (LDL-C) and total cholesterol (TC), were observed also. Results As compared to conventional western therapies, Changxinyin Decoction could further alleviate angina pectoris, reduce scores of TCM syndromes, and further lower the levels of TIB, hs-CRP,LDL-C, and TC. Conclusion Changxinyin Decoction can alleviate cardiac ischemia; the underlying mechanisms might be related with lowering blood lipids, and inhibiting the inflammation in the coronary artery.%目的 观察畅心饮对冠心病心绞痛与中医证候疗效、心肌缺血的改善作用,并探究其可能机制.方法 将66例冠心病患者分为2组,对照组(32例)按常规西医治疗,治疗组(34例)在常规西医治疗基础上加服畅心饮,观察畅心饮对心绞痛与中医证候的疗效及对缺血总负荷(total ischemic burden,TIB)、体质量指数(body mass index,BMI)、超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)以及低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C )和总胆固醇(total cholesterol,TC)的影响.结果 与对

  13. Renal neurohormonal regulation in heart failure decompensation.

    Science.gov (United States)

    Jönsson, Sofia; Agic, Mediha Becirovic; Narfström, Fredrik; Melville, Jacqueline M; Hultström, Michael

    2014-09-01

    Decompensation in heart failure occurs when the heart fails to balance venous return with cardiac output, leading to fluid congestion and contributing to mortality. Decompensated heart failure can cause acute kidney injury (AKI), which further increases mortality. Heart failure activates signaling systems that are deleterious to kidneys such as renal sympathetic nerve activity (RSNA), renin-angiotensin-aldosterone system, and vasopressin secretion. All three reduce renal blood flow (RBF) and increase tubular sodium reabsorption, which may increase renal oxygen consumption causing AKI through renal tissue hypoxia. Vasopressin contributes to venous congestion through aquaporin-mediated water retention. Additional water retention may be mediated through vasopressin-induced medullary urea transport and hyaluronan but needs further study. In addition, there are several systems that could protect the kidneys and reduce fluid retention such as natriuretic peptides, prostaglandins, and nitric oxide. However, the effect of natriuretic peptides and nitric oxide are blunted in decompensation, partly due to oxidative stress. This review considers how neurohormonal signaling in heart failure drives fluid retention by the kidneys and thus exacerbates decompensation. It further identifies areas where there is limited data, such as signaling systems 20-HETE, purines, endothelin, the role of renal water retention mechanisms for congestion, and renal hypoxia in AKI during heart failure.

  14. Intercellular communication lessons in heart failure.

    Science.gov (United States)

    Bang, Claudia; Antoniades, Charalambos; Antonopoulos, Alexios S; Eriksson, Ulf; Franssen, Constantijn; Hamdani, Nazha; Lehmann, Lorenz; Moessinger, Christine; Mongillo, Marco; Muhl, Lars; Speer, Thimoteus; Thum, Thomas

    2015-11-01

    Cell-cell or inter-organ communication allows the exchange of information and messages, which is essential for the coordination of cell/organ functions and the maintenance of homeostasis. It has become evident that dynamic interactions of different cell types play a major role in the heart, in particular during the progression of heart failure, a leading cause of mortality worldwide. Heart failure is associated with compensatory structural and functional changes mostly in cardiomyocytes and cardiac fibroblasts, which finally lead to cardiomyocyte hypertrophy and fibrosis. Intercellular communication within the heart is mediated mostly via direct cell-cell interaction or the release of paracrine signalling mediators such as cytokines and chemokines. However, recent studies have focused on the exchange of genetic information via the packaging into vesicles as well as the crosstalk of lipids and other paracrine molecules within the heart and distant organs, such as kidney and adipose tissue, which might all contribute to the pathogenesis of heart failure. In this review, we discuss emerging communication networks and respective underlying mechanisms which could be involved in cardiovascular disease conditions and further emphasize promising therapeutic targets for drug development.

  15. Anticoagulant management of pregnant women with mechanical heart valve replacement during perioperative period%心脏瓣膜置换术后妊娠妇女围手术期的抗凝管理

    Institute of Scientific and Technical Information of China (English)

    綦小蓉; 边策; 李黎; 赵际童; 刘兴会

    2015-01-01

    Objective: To investigate suitable anticoagulation in perioperative with women who received mechanical heart valve replacement. Method:34 pregnant women with mechanical heart valve replacement who received low-dose oral anticoagulation treatment from Oct. 2008 to Jul. 2012 treated at West China Women's and Children's Hospital were retrospec-tively reviewed. 7 patients received emergency cesarean section,while 27 patients received se-lective cesarean section,in which 13 patients received single oral warfarin postpartum and 14 patients received “bridging treatment”. Morbidity of complications and the time to achieve the target INR after operation were compared. Results:34 full-terms healthy babies were delivered and no maternal thromboembolic was observed during pregnancy. There was no significant difference of the amount of vaginal bleeding between single oral warfarin group and “bridging treatment” group during postpartum period. In single oral warfarin group,one valve thrombosis was observed and leaded to sudden death. No periphery thrombosis,hematoma,general hemor-rhage or other sign of over-anticoagulation was observed. The INR increased more slowly in the group who received emergency operation with preoperative application of vitamin K1 than other two groups. Conclusion:The use of vitamin K1 preoperatively might result in warfarin resistance and discontinue warfarin therapy before selective cesarean section might be more appropriate than application of vitamin K1. The “ bridging treatment” which combines oral warfarin and subcutaneous LMWH might be more effective and safer than single oral warfarin therapy for pa-tients with mechanical heart valve replacement during postoperative period,no matter selective or emergency cesarean section. The safty of low-dose oral wafarin therapy thoughout preganancy is still under controversy.%目的::探讨心脏机械瓣膜置换术后妊娠妇女围手术期适宜的抗凝方案。方法:回顾分析2008

  16. Heart to Heart Art: Empowering Homeless Children and Youth

    Science.gov (United States)

    Shepard, Jerri; Booth, Deborah

    2009-01-01

    This article describes Heart to Heart Art, an after-school program developed for homeless children and youth at the YWCA in Spokane, Washington. Pre-service teacher candidates from a local university create meaningful activities that engage homeless students in visual art, music, drama, cooking, and community service. Heart to Heart Art was…

  17. Isolated heart models: cardiovascular system studies and technological advances.

    Science.gov (United States)

    Olejnickova, Veronika; Novakova, Marie; Provaznik, Ivo

    2015-07-01

    Isolated heart model is a relevant tool for cardiovascular system studies. It represents a highly reproducible model for studying broad spectrum of biochemical, physiological, morphological, and pharmaceutical parameters, including analysis of intrinsic heart mechanics, metabolism, and coronary vascular response. Results obtained in this model are under no influence of other organ systems, plasma concentration of hormones or ions and influence of autonomic nervous system. The review describes various isolated heart models, the modes of heart perfusion, and advantages and limitations of various experimental setups. It reports the improvements of perfusion setup according to Langendorff introduced by the authors.

  18. Anticoagulation property and security of artificial heart valve material

    Institute of Scientific and Technical Information of China (English)

    WANG; Xianghui; LIU; Xianghuai; ZHANG; Feng; LI; Changron

    2005-01-01

    Heart valve diseases threaten human health. One reliable way to save lives of such patients is to replace the pathologically changed heart valves by artificial ones. Over 2 million patients have received LTI-carbon heart valve's implantation. However, the thrombosis after the implantation is one of the difficulties that need to be solved. In order to improve the blood compatibility and security of mechanical heart valves, ion beam technology was used to modify the surface properties of the materials. The investigation results have been summarized in this paper.

  19. Direct myocardial perfusion imaging in valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Soto, R.C.; Durante, M.L.; Villacorta, E.V.; Torres, J.F.; Monzon, O.P.

    1981-02-01

    Twenty two patients with rheumatic valvular heart disease - 21 having a history of heart failure - were studied using direct coronary injection of /sup 99m/Tc labelled MAA particles during the course of hemodynamic and arteriographic studies. Myocardial perfusion deficit patterns have been shown to be consistent or indicative of either patchy, regional or gross ischemia. In patients with history of documented heart failure 90% (18 cases) had ischemic perfusion deficit in the involved ventricle. We conclude that diminished myocardial blood flow is an important mechanism contributing to the development of heart failure.

  20. Depressive symptoms are related to decreased low-frequency heart rate variability in older adults with decompensated heart failure

    NARCIS (Netherlands)

    Guinjoan, Salvador M.; Castro, Mariana N.; Vigo, Daniel E.; Weidema, Hylke; Berbara, Carlos; Fahrer, Rodolfo D.; Grancelli, Hugo; Nogues, Martin; Leiguarda, Ramon C.; Cardinali, Daniel P.

    2007-01-01

    Background/Aims: Depression has been associated with increased mortality among individuals with heart failure, but the mechanism for this association is unsettled. Depression is often found to result in autonomic dysfunction which, if present in heart failure, might help explain worsened outcomes. M

  1. Heart PET scan

    Science.gov (United States)

    ... nuclear medicine scan; Heart positron emission tomography; Myocardial PET scan ... A PET scan requires a small amount of radioactive material (tracer). This tracer is given through a vein (IV), ...

  2. Hyperkalemia in Heart Failure.

    Science.gov (United States)

    Sarwar, Chaudhry M S; Papadimitriou, Lampros; Pitt, Bertram; Piña, Ileana; Zannad, Faiez; Anker, Stefan D; Gheorghiade, Mihai; Butler, Javed

    2016-10-01

    Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure.

  3. Heart Attack Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for...

  4. Cyanotic heart disease

    Science.gov (United States)

    ... checking it through the skin with a pulse oximeter Complete blood count (CBC) ECG (electrocardiogram) Looking at ... the groin ( cardiac catheterization ) Transcutaneous oxygen monitor (pulse oximeter) Echo-Doppler Testing the heart's electrical system

  5. Heart Surgery Terms

    Science.gov (United States)

    ... Patients Choosing Wisely® Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk Adjustment? Valve Repair/Replacement Surgery Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery Clinical ...

  6. Congenital heart disease

    Science.gov (United States)

    ... blood sugar level. Certain genes may play a role in congenital heart disease. Many family members may be affected. Talk to your provider about genetic counseling and screening if you have a family history ...

  7. Inflammation and Heart Disease

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Inflammation and Heart Disease Updated:Apr 18,2016 Understand the risks of inflammation. Although it is not proven that inflammation causes ...

  8. Stress and your heart

    Science.gov (United States)

    Coronary heart disease - stress; Coronary artery disease - stress ... Your body responds to stress on many levels. First, it releases stress hormones that make you breathe faster. Your blood pressure goes up. Your muscles ...

  9. American Heart Association

    Science.gov (United States)

    ... American Heart area Search by State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) Tiếng Việt (Vietnamese) Healthy Living Conditions Caregiver ...

  10. Heart Truth for Latinas

    Science.gov (United States)

    ... for about a fifth. Latinas also have high rates of some factors that increase the risk of developing heart disease, such as diabetes, overweight and obesity, and physical inactivity. But there’s good news too: ...

  11. Protein and Heart Health

    Science.gov (United States)

    ... Recognition & Awards Healthy Workplace Food and Beverage Toolkit Protein and Heart Health Updated:May 5,2015 Protein ... said. What’s the harm in getting too much protein? The main problem is that often the extra ...

  12. Heart failure overview

    Science.gov (United States)

    ... smoke . Stay active. Walk or ride a stationary bicycle. Your provider can provide a safe and effective ... at the same time. A defibrillator sends an electrical pulse to stop life-threatening abnormal heart rhythms. ...

  13. Keeping Hearts Pumping

    Science.gov (United States)

    2002-01-01

    A collaboration between NASA, Dr. Michael DeBakey, Dr. George Noon, and MicroMed Technology, Inc., resulted in a life-saving heart pump for patients awaiting heart transplants. The MicroMed DeBakey VAD functions as a "bridge to heart transplant" by pumping blood throughout the body to keep critically ill patients alive until a donor heart is available. Weighing less than 4 ounces and measuring 1 inch by 3 inches, the pump is approximately one-tenth the size of other currently marketed pulsatile VADs. This makes it less invasive and ideal for smaller adults and children. Because of the pump's small size, less than 5 percent of the patients implanted developed device-related infections. It can operate up to 8 hours on batteries, giving patients the mobility to do normal, everyday activities.The MicroMed DeBakey VAD is a registered trademark of MicroMed Technology, Inc.

  14. Music and the heart.

    Science.gov (United States)

    Koelsch, Stefan; Jäncke, Lutz

    2015-11-21

    Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR increase. Moreover, HR and RR tend to increase in response to music compared with silence, and HR appears to decrease in response to unpleasant music compared with pleasant music. We found no studies that would provide evidence for entrainment of HR to musical beats. Corresponding to the increase in HR, listening to exciting music (compared with tranquilizing music) is associated with a reduction of heart rate variability (HRV), including reductions of both low-frequency and high-frequency power of the HRV. Recent findings also suggest effects of music-evoked emotions on regional activity of the heart, as reflected in electrocardiogram amplitude patterns. In patients with heart disease (similar to other patient groups), music can reduce pain and anxiety, associated with lower HR and lower BP. In general, effects of music on the heart are small, and there is great inhomogeneity among studies with regard to methods, findings, and quality. Therefore, there is urgent need for systematic high-quality research on the effects of music on the heart, and on the beneficial effects of music in clinical settings. PMID:26354957

  15. Malnutrition and the heart.

    OpenAIRE

    Webb, J G; Kiess, M C; Chan-Yan, C C

    1986-01-01

    Earlier concepts that the heart is spared in malnutrition have been shown to be incorrect. Inadequate intake of protein and energy results in proportional loss of skeletal and myocardial muscle. As myocardial mass decreases, so does the ability to generate cardiac output; however, various compensatory factors come into play. Nutritional supplementation for malnourished patients reverses the compensatory factors and may increase the short-term potential for heart failure. Severe cardiac debili...

  16. ST2 IN REJECTION OF THE TRANSPLANTED HEART

    Directory of Open Access Journals (Sweden)

    O. P. Shevchenko

    2015-01-01

    Full Text Available This review summarizes the current literature devoted to the analysis of prognostic role of ST2 biomarker in rejection of the transplanted heart. ST2 is one of the most promising diagnostic markers of the development and severity of heart failure as well as the mortality risk in patients with cardiovascular diseases. ST2 is expressed in cardiomyocytes in response to a variety of pathological processes and mechanical damage to the heart, which allows diagnosing cardiovascular diseases before clinical manifestations. Presumably, measuring the level of ST2 in heart transplant may have diagnostic and prognostic value in the assessment of graft and risk of rejection. Currently, accumulated clinical data on the role of given biomarker in heart transplantation are not enough, and further research on the relation of ST2 levels with different clinical and laboratory parameters in heart recipients is necessary. 

  17. Genome-wide association studies and resting heart rate

    DEFF Research Database (Denmark)

    Oskari Kilpeläinen, Tuomas

    2016-01-01

    Genome-wide association studies (GWASs) have revolutionized the search for genetic variants regulating resting heart rate. In the last 10 years, GWASs have led to the identification of at least 21 novel heart rate loci. These discoveries have provided valuable insights into the mechanisms...... and pathways that regulate heart rate and link heart rate to cardiovascular morbidity and mortality. GWASs capture majority of genetic variation in a population sample by utilizing high-throughput genotyping chips measuring genotypes for up to several millions of SNPs across the genome in thousands...... of individuals. This allows the identification of the strongest heart rate associated signals at genome-wide level. While GWASs provide robust statistical evidence of the association of a given genetic locus with heart rate, they are only the starting point for detailed follow-up studies to locate the causal...

  18. Heart Procurement from a Donor on Venovenous ECMO Support.

    Science.gov (United States)

    Singh, Gopal; Tsukashita, Masaki; Biscotti, Mauer; Costa, Joseph; Lambert, Daniel; Bacchetta, Matthew; Takayama, Hiroo

    2016-01-01

    We report the case of a 37-year-old woman with acute respiratory distress syndrome and became a candidate for organ donation after anoxic brain injury and was on a venovenous extracorporeal membrane oxygenation (VV-ECMO) support. On preoperative evaluation and gross examination, the donor's heart was acceptable for heart transplantation to a 62-year-old female patient with a history of nonischemic cardiomyopathy with a HeartMate II mechanical assist device. Orthotopic heart transplantation was successfully performed in the recipient. We report a case that suggests that the procurement of a heart from a donor on ECMO support can potentially expand the donor heart pool in carefully selected patients. PMID:26536537

  19. Is Heart Rate a Norepiphenomenon in Heart Failure?

    Science.gov (United States)

    Hensey, Mark; O'Neill, James

    2016-09-01

    There has been an increased focus on heart rate as a target in the management of cardiovascular disease and more specifically in heart failure with preserved ejection fraction in recent years with several studies showing the benefit of a lower resting heart rate on outcomes. This review paper examines the pathophysiology behind the benefits of lowering heart rate in heart failure and also the evidence for and against the pharmacological agents available to achieve this. PMID:27457085

  20. Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?

    Directory of Open Access Journals (Sweden)

    Christine H. Attenhofer Jost

    2013-01-01

    Full Text Available Due to impressive improvements in surgical repair options, even patients with complex congenital heart disease (CHD may survive into adulthood and have a high risk of end-stage heart failure. Thus, the number of patients with CHD needing heart transplantation (HTx has been increasing in the last decades. This paper summarizes the changing etiology of causes of death in heart failure in CHD. The main reasons, contraindications, and risks of heart transplantation in CHD are discussed and underlined with three case vignettes. Compared to HTx in acquired heart disease, HTx in CHD has an increased risk of perioperative death and rejection. However, outcome of HTx for complex CHD has improved over the past 20 years. Additionally, mechanical support options might decrease the waiting list mortality in the future. The number of patients needing heart-lung transplantation (especially for Eisenmenger’s syndrome has decreased in the last years. Lung transplantation with intracardiac repair of a cardiac defect is another possibility especially for patients with interatrial shunts. Overall, HTx will remain an important treatment option for CHD in the near future.

  1. STUDY ON THE RELATIONSHIP AMONG THE HEART MERIDIAN,CARDIAC REFERRED PAIN AND THE HEART

    Institute of Scientific and Technical Information of China (English)

    RONGPeijing; ZHUBing

    2002-01-01

    Purpose:The referred pain of the somatic structure,a response of the visceralgia,is often seen in clinic.But ist underlying mechanisms are poorly understood.It is interested that cardiac referred pain ofter appears along the running course of the Heart Meridian(HM),while acupuncture of the acupoints of HM can effectively relieve cardiac pain.In the present study,the neural basis of the relationship among the HM,cardiac referred pain and the heart is investigated by using tri-labeling technique.Methods:Wistar rats are used in the present study.Three fluorescent dyes,fast blue(FB),propidium lodide(PI) and bibenzimide(Bb)are respectively injected into the pericardial sac,the left and right medial-middle band (HM) or lateral sides[rung Meridian(LM),used for control] of the rat forearms.Results:Examination of the sections of the dorsal ganglions shows that more doubly labeled neurons are found in the ipsilateral dorsal root ganglions of C8-T3 nerve segments from HM and the heart,while fewer double-labeled neurons found from LM and the heart.The facts provide direct evidence for existence of dichotomizing fibers of the ganglion neurons.There exists a relative specific connection between the HM and the heart.It also provides a morphological explanation for cardiogenic referred pain and for the specific interrelation between the heart Meridian and the heart of traditional Chinese medicine.

  2. All about Heart Rate (Pulse)

    Science.gov (United States)

    ... July 2015. Cardiovascular Conditions • Conditions Home • Arrhythmia and Atrial Fibrillation • Cardiac Arrest • Cardiac Rehab • Cardiomyopathy • Cardiovascular Conditions of Childhood • Cholesterol • Congenital Heart Defects • Diabetes • Heart Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  3. Nutrition in Heart Failure

    Directory of Open Access Journals (Sweden)

    Reci Meseri

    2013-10-01

    Full Text Available Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilemma. Since one of the main reasons of heart failure is cardiovascular diseases, in first phase, the patient may be obese. In the later phases, cachexia may show up. It was shown that cachexia is associated with mortality. Within this period, patients should not be over-fed and the patient should pass from catabolic state to anabolic state slowly. If the gastrointestinal track is functional oral/enteral feeding must be preferred. Multi vitamin and mineral supportsmay be beneficial, which may replace the increased loss, increase anti-inflammatory response and be anti-oxidants. Large, controlled and well-designed studies must be conducted in order to evaluate the benefits of nutritional practices such as nutritional assessment, enteral feeding and nutrient supports in heart failure patients.

  4. Interplay between cardiac function and heart development.

    Science.gov (United States)

    Andrés-Delgado, Laura; Mercader, Nadia

    2016-07-01

    Mechanotransduction refers to the conversion of mechanical forces into biochemical or electrical signals that initiate structural and functional remodeling in cells and tissues. The heart is a kinetic organ whose form changes considerably during development and disease. This requires cardiomyocytes to be mechanically durable and able to mount coordinated responses to a variety of environmental signals on different time scales, including cardiac pressure loading and electrical and hemodynamic forces. During physiological growth, myocytes, endocardial and epicardial cells have to adaptively remodel to these mechanical forces. Here we review some of the recent advances in the understanding of how mechanical forces influence cardiac development, with a focus on fluid flow forces. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  5. Mitochondrial dysfunction in heart failure.

    Science.gov (United States)

    Rosca, Mariana G; Hoppel, Charles L

    2013-09-01

    Heart failure (HF) is a complex chronic clinical syndrome. Energy deficit is considered to be a key contributor to the development of both cardiac and skeletal myopathy. In HF, several components of cardiac and skeletal muscle bioenergetics are altered, such as oxygen availability, substrate oxidation, mitochondrial ATP production, and ATP transfer to the contractile apparatus via the creatine kinase shuttle. This review focuses on alterations in mitochondrial biogenesis and respirasome organization, substrate oxidation coupled with ATP synthesis in the context of their contribution to the chronic energy deficit, and mechanical dysfunction of the cardiac and skeletal muscle in HF. We conclude that HF is associated with decreased mitochondrial biogenesis and function in both heart and skeletal muscle, supporting the concept of a systemic mitochondrial cytopathy. The sites of mitochondrial defects are located within the electron transport and phosphorylation apparatus and differ with the etiology and progression of HF in the two mitochondrial populations (subsarcolemmal and interfibrillar) of cardiac and skeletal muscle. The roles of adrenergic stimulation, the renin-angiotensin system, and cytokines are evaluated as factors responsible for the systemic energy deficit. We propose a cyclic AMP-mediated mechanism by which increased adrenergic stimulation contributes to the mitochondrial dysfunction.

  6. Community - based Rehabilitation and Health Management in Patients with Mechanical Heart Valve Replacement%人工机械瓣膜置换术后患者的社区康复管理

    Institute of Scientific and Technical Information of China (English)

    胡丕; 余舜; 胡知朋

    2014-01-01

    Objective To explore the significance of community - based rehabilitation and health management in pre-venting and treating long - term complications after mechanical heart valve replacement, Methods During February 2001 to July 2012,83 prosthetic valve implanted patients were included and their health archives were established, All the patients included were given health education,periodic physical examination and complication diagnosis and treatment, Results Follow - up to May 1st,2013,of the 83 patients,no one died of valve disease or complications but three patients(3, 6% )died of lung canc-er,trauma and gastric cancer respectively;79 patients(95, 2% )reached the presupposed anticoagulation standard;8 patients (9, 6% )experienced hemorrhagic tendency and one patient were diagnosed as encephalorrhagia by using MRI;3 patients (3, 6% )were diagnosed as cardiac function NAHY grade Ⅱ and their heart failure was induced by pneumonia,anemia and over-work respectively,but no cardiac shock occurred;3 patients(3, 6% )were diagnosed as atrial fibrillation for the first time and 2 patients(2, 4% )experienced worsened atrial fibrillation that obviously influenced haemodynamics;One patient(1, 2% )ex-perienced ventricular arrhythmias following the infective endocarditis, Conclusion Community - based rehabilitation and health management is of great significance for preventing and treating the long - term complications after prosthetic valve replacement.%目的:探讨社区康复管理在防治人工机械瓣膜置换术后患者远期并发症中的意义。方法2001年2月—2012年7月,共计83例金属瓣膜置换患者在杨柳湾镇中心卫生院建立健康档案,接受系统的健康宣教、定期体检、并发症判断和处理。结果随访至2013-05-01,本组患者死亡3例(3,6%),死亡原因为肺癌、创伤、胃癌各1例,无一例因心脏瓣膜病或相关并发症死亡;总抗凝达标人数79例(95,2%);出血倾向8例(9,6%

  7. The aging heart.

    Science.gov (United States)

    Klausner, S C; Schwartz, A B

    1985-02-01

    Pathologic studies of the myocardium and valvular structures have failed to provide convincing evidence of gross or microscopic changes that can be ascribed to aging alone. Lipofuscin accumulation and basophilic degeneration in cardiac muscle cells appear to be the most consistent findings associated with aging, but they are found in other conditions. Without doubt, pathologic changes in the myocardium, valves, and coronary arteries are found more frequently in the hearts of elderly persons, but those changes are caused by disease processes associated with an aging population rather than the aging process itself. Both the sinus and atrioventricular nodes decrease in size with age owing to a loss of cellularity. These structures become infiltrated with collagen, elastic tissue, and reticular fibers. Some have found infiltration also with fat. Amyloid deposition, basophilic degeneration of cells, and lipofuscin accumulation occur but probably do not cause functional abnormalities. Similar but less dramatic changes occur in the bundle of His and individual bundle branches. Most of the data suggests that these aging changes are not due to vascular insufficiency. Age-related changes in intrinsic mechanical function have been identified as a prolongation of contraction duration, decreased inotropic responses to catecholamines and cardiac glycosides, and an increase in mechanical refractoriness. Other possible age-related changes include alterations in relaxation, which may or may not be independent of the prolongation of contraction, and changes in the viscoelastic properties of cardiac muscle. When examined in the context of the components of a model of excitation-contraction coupling, changes in action potential duration and the function of the sarcoplasmic reticulum emerge as the most likely bases for the changes. The electrical characteristics of sinus, atrioventricular, and His-Purkinje cells as well as atrial and ventricular muscle cells change with age. The sinus

  8. Clinical use of novel biomarkers in heart failure : towards personalized medicine

    NARCIS (Netherlands)

    Schmitter, Daniela; Cotter, Gadi; Voors, Adriaan A.

    2014-01-01

    Biomarkers play an important role in heart failure. They provide us information about the mechanisms involved in specific types of heart failure and can identify patients at higher risk. Although the majority of biomarker studies in heart failure focus on their prognostic value, the clinical applica

  9. Genomic and nongenomic effects of aldosterone in the rat heart : why is spironolactone cardioprotective?

    NARCIS (Netherlands)

    Chai, WX; Garrelds, IM; Arulmani, U; Schoemaker, RG; Lamers, JMJ; Danser, AHJ

    2005-01-01

    1 Mineralocorticoid receptor (MR) antagonism with spironolactone reduces mortality in heart failure on top of ACE inhibition. To investigate the underlying mechanism, we compared the actions of both aldosterone and spironolactone to those of angiotensin (Ang) II in the rat heart. 2 Hearts of male Wi

  10. 78 FR 67370 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-11-12

    ... of Committee: Heart, Lung, and Blood Initial Review Group; Heart, Lung, and Blood Program Project..., Lung, and Blood Initial Review Group; NHLBI Institutional Training Mechanism Review Committee. Date... HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of...

  11. A novel approach in cross-linking of bioprosthetic heart valves

    NARCIS (Netherlands)

    Everaerts, Fransiscus Joannes Leonardus

    2007-01-01

    Due to some form of heart valve disease, approximately 250000 patients worldwide undergo surgery to receive a new heart-valve each year. In about 70% of the cases a mechanical heart valve is used despite the fact that permanent anticoagulant therapy for the patient is required. The remaining 30% of

  12. [EFFICIENCY OF COMBINATION OF ROFLUMILAST AND QUERCETIN FOR CORRECTION OXYGEN- INDEPENDENT MECHANISMS AND PHAGOCYTIC ACTIVITY OF MACROPHAGE CELLS OF PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WHEN COMBINED WITH CORONARY HEART DISEASE].

    Science.gov (United States)

    Gerych, P; Yatsyshyn, R

    2015-01-01

    Studied oxygen independent reaction and phagocytic activity of macrophage cells of patients with chronic obstructive pulmonary disease (COPD) II-III stage when combined with coronary heart disease (CHD). The increasing oxygen independent reactions monocytes and neutrophils and a decrease of the parameters that characterize the functional state of phagocytic cells, indicating a decrease in the functional capacity of macrophage phagocytic system (MPS) in patients with acute exacerbation of COPD, which runs as its own or in combination with stable coronary heart disease angina I-II. FC. Severity immunodeficiency state in terms of cellular component of nonspecific immunity in patients with acute exacerbation of COPD II-III stage in conjunction with the accompanying CHD increases with the progression of heart failure. Inclusion of basic therapy of COPD exacerbation and standard treatment of coronary artery disease and drug combinations Roflumilastand quercetin causes normalization of phagocytic indices MFS, indicating improved immune status and improves myocardial perfusion in terms of daily ECG monitoring.

  13. Study on mechanism of ANP release and cardiac antioxidation on exhausted heart%心房钠尿肽对力竭小鼠心脏抗氧化作用及其分泌机制的研究

    Institute of Scientific and Technical Information of China (English)

    洪兰; 刘丽萍; 于丽; 李海雁; 崔勋

    2012-01-01

    目的 观察游泳力竭小鼠心肌组织中乳酸(lactic acid,LD)含量及血浆心房钠尿肽(atria1 natriuretic peptide,ANP)的分泌,以探讨力竭心脏的ANP分泌作用及抗氧化作用机制.方法 ①对小鼠进行分组及负重游泳,力竭即测试心肌LD和血浆ANP含量;②采用家兔离体心房灌流模型,利用不同浓度的乳酸缓冲液(4、8和12 mmo1/L)及其氮气模拟力竭心脏,探讨力竭心脏分泌ANP的机制;③利用氮气复制缺氧家兔离体心房灌流模型模拟力竭心脏,观察力竭心肌MDA含量的变化及其机制探讨.结果 ①游泳力竭小鼠心肌组织LD(P<0.01)和血浆ANP含量(P<0.01)与对照组相比均明显增高;②灌流浓度分别为4mmol/L(P <0.05)、8 mmo1/L (P<0 05)和12rmmol/L(P <0.001)的乳酸缓冲液与对照组相比并不增加离体心房灌流模型中ANP的分泌,反而抑制ANP的分泌;但缺氧能明显增加心房ANP的释放(与对照组相比,P<0.001);③缺氧的离体心房灌流模型显示,缺氧组心肌组织中MDA含量比对照组显著降低(P<00S),而预处理KT5823(1mmol/L)再给予缺氧组心肌组织中MDA含量明显增高(与缺氧组相比,P<0.01).结论 ①力竭心脏的缺氧分泌大量ANP,而不是乳酸.②力竭时分泌的ANP对心脏具有抗氧化作用,其作用是通过ANP→cGMP→PKG信号传导途径.%[Objectives] To observe the secretion of the ANP and study the cardiac antioxidation and mechanism of ANP release on exhausted heart. [Methods] Experimental animals were grouped and swimmed, the exhausted mouse was tested the lactic acid (LD) and ANP in blood plasma; To observe the effect of hypoxia and LD on ANP secretion in the exhausted heart by the isolated perfused beating rabbit atria; To observed the MDA content in the exhausted myocardium which pretreatment and non-pretreatment KT5823 (1 mmol/L) (PKG inhibiter) by isolated perfused beating rabbit atria. [Results] The LD in myocardium (P< 0.01) and ANP in

  14. 心脏机械瓣膜置换术后华法林低强度抗凝疗效观察%Efficacy of warfarin low intense anticoagulation after heart valve replacement

    Institute of Scientific and Technical Information of China (English)

    刘状; 葛圣林; 张成鑫

    2014-01-01

    anticoagulation at the 1st Affiliated Hospital of Anhui Medical University from January 2010 to January 2013 .During the follow-up,we recorded the prothrombin time ( PT) ,international normalized ratio ( INR) and oral war-farin dose and thromboembolism/hemorrhage complications .Results Complete data were obtained of 469 patients which were followed up for an average of 18.13 ±6.02 months (range 1~37 months),totally followed up 1 960.8p-ys.Two hundred and eleven were males and two hundred and fifty-eight were females with a mean age of 40.52 ±13.38 years.A total of 268 patients had MVR,115 patients AVR,and 86 patients DVR.Valves implanted were all bileaflet ,of which 153 were St.Jude Regent,291 CarboMedics,and 111 GKS. Average INR was 2.11 ±0.56,and warfarin dose was (3.124 ±2.4) mg.There were 47 cases of anticoagulation-related complications ,of which 37 were anticoagulation-related hemorrhage (1.89%pt-y),and 10 were anticoagulation-related thromboembolism (0.51%pt-y). And 5 patients died,of which 3 were anticoagulation related .Among all of these patients ,316 were complicated by atrial fibrillation and 43 by left atrial thrombosis .Conclusions Anticoagulation for mechanical heart valve replacement can be managed with INR levels within the range of 1.8~2.2 ,which can prevent hemorrhagic and thromboembolic events .Patients with atrial fibrillation and double valve replace-ment have higher anticoagulation-related morbidity ,which should have higher frequency of review and timely adjustment of warfarin dose .

  15. 1例心脏病术后患者华法林抗凝治疗的用药分析%Analysis of Anticoagulant Therapy for a Patient after Mechanical Heart Valve Replacement

    Institute of Scientific and Technical Information of China (English)

    吴晓丽; 周玲

    2015-01-01

    1例46岁男性患者,既往有房颤及脑梗塞病史,二尖瓣机械瓣膜置换术后予以华法林抗凝治疗。根据药物基因检测及合并用药情况,初始给予华法林2.5 mg po qd,监测INR值偏低,华法林调整至3.75 mg po qd后出院,一月后复查INR 1.64。在随访过程中,临床药师发现该患者出院后自2014年10月至2015年1月,华法林剂量上调,但抗凝效果不佳,有栓塞风险。经详细了解后,考虑与患者服药依从性差相关,建议家属严格监督患者每日按时按量服用华法林,在饮食上避免长期摄入大量含有维生素K的食物并戒酒,一周后复查INR为1.46,接近合适范围。%A 46-year-old male patient, who has a history of atrial fibrillation and cerebral infarction, has taken warfarin-anticoagulant therapy after mechanical heart valve replacement. According to the results of drug genetic testing and drug combination, an abnormal low international standardization ration (INR) was observed when the initial warfarin dosage was 2.5 mg po qd, which indicated the risk of thrombosis. The warfarin dosage was adjusted to 3.75 mg po qd as the patient left hospital and then INR was 1.64 when rechecked one month later. At follow-up, with the increasing dosage of warfarin, the anticoagulant effect was not satisfactory from October 2014 to January 2015. After the detailed investigation, the clinical pharmacists considered the unsatisfactory anticoagulant effect was related to the poor compliance of the patient. The family dependents of the patient were advised to strictly supervise the patient to take warfarin timely and quantitatively and the patient was exhorted to avoid long-term foods with large amounts of vitamin K and forbear from alcohols. INR was 1.46 when rechecked one week later, which was close to the target range.

  16. C型利钠肽扩张猪冠状动脉的作用及机制的研究%The Effects and Mechanism of C-Type Natriuretic Peptides on Swine Heart Coronary Artery

    Institute of Scientific and Technical Information of China (English)

    舒燕; 李其勇; 姜荣建; 孔洪

    2015-01-01

    目的:本研究通过离体灌流方法观察C型利钠肽( CNP)对离体猪冠状动脉血管张力的影响,探讨C型利钠肽的扩血管能力及其机制。方法本实验分为三组:C型利钠肽组( CNP组)、硝酸甘油组( GTN组)、利钠肽受体C (NPR-C)激动剂组(cANF4-23组)。①上述各组中分别加入去甲肾上腺素(NE),然后分别加入GTN、CNP和cANF4-23,比较CNP和硝酸甘油对冠状动脉的扩张能力,并了解cANF4-23是否有扩血管作用。②在CNP组预先加入NPR-C受体抑制剂(cANF4-28),比较加药前后的扩血管作用变化。③80mM高钾溶液预收缩血管,然后分别加入CNP、cANF4-23,观察高钾对CNP和cANF4-23扩血管作用的影响。结果①CNP、NPR-C受体激动剂(cANF4-23)及硝酸甘油均有明显的舒血管作用。 CNP组舒血管作用与cANF4-23组类似,低于GTN组,差异有统计学意义( P0. 05). The vasodilatory influence of CNP Group was weaker than GTN Group (P<0. 05).②In cANF4-28 preserved arteries, The largest circulus vasculosus vasodilatory ratios of CNP was significantly weaker than Control Group , and had statistical significance (P<0. 01).③The vasodilatory influences of CNP and cANF4-23 Groups were significantly decreased in high concentration K + solution in contrast with the Control Group ( P<0. 05 ) , but not blocked. Conclusions C- Natriuretic peptides have significant vasodilatory influence on swine heart coronary artery. The vasodilatory mechanism of CNP involves NPR-C. NPR-C is not only the well-known clearance receptor, but also leads to vasodilation of the coronary artery. the vasodilatory of CNP/NPR-C sig-naling involves K+ channel.

  17. Theory of heart biomechanics, biophysics, and nonlinear dynamics of cardiac function

    CERN Document Server

    Hunter, Peter; McCulloch, Andrew

    1991-01-01

    In recent years there has been a growth in interest in studying the heart from the perspective of the physical sciences: mechanics, fluid flow, electromechanics. This volume is the result of a workshop held in July 1989 at the Institute for Nonlinear Sciences at the University of California at San Diego that brought together scientists and clinicians with graduate students and postdoctoral fellows who shared an interest in the heart. The chapters were prepared by the invited speakers as didactic reviews of their subjects but also include the structure, mechanical properties, and function of the heart and the myocardium, electrical activity of the heart and myocardium, and mathematical models of heart function.

  18. Remodeling in the ischemic heart: the stepwise progression for heart

    Directory of Open Access Journals (Sweden)

    J.G. Mill

    2011-09-01

    Full Text Available Abstract Coronary artery disease is the leading cause of death in the developed world and in developing countries. Acute mortality from acute myocardial infarction (MI has decreased in the last decades. However, the incidence of heart failure (HF in patients with healed infarcted areas is increasing. Therefore, HF prevention is a major challenge to the health system in order to reduce healthcare costs and to provide a better quality of life. Animal models of ischemia and infarction have been essential in providing precise information regarding cardiac remodeling. Several of these changes are maladaptive, and they progressively lead to ventricular dilatation and predispose to the development of arrhythmias, HF and death. These events depend on cell death due to necrosis and apoptosis and on activation of the inflammatory response soon after MI. Systemic and local neurohumoral activation has also been associated with maladaptive cardiac remodeling, predisposing to HF. In this review, we provide a timely description of the cardiovascular alterations that occur after MI at the cellular, neurohumoral and electrical level and discuss the repercussions of these alterations on electrical, mechanical and structural dysfunction of the heart. We also identify several areas where insufficient knowledge limits the adoption of better strategies to prevent HF development in chronically infarcted individuals.

  19. Nonlinear and stochastic dynamics in the heart

    Energy Technology Data Exchange (ETDEWEB)

    Qu, Zhilin, E-mail: zqu@mednet.ucla.edu [Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, CA 90095 (United States); Hu, Gang [Department of Physics, Beijing Normal University, Beijing 100875 (China); Garfinkel, Alan [Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, CA 90095 (United States); Department of Integrative Biology and Physiology, University of California, Los Angeles, CA 90095 (United States); Weiss, James N. [Department of Medicine (Cardiology), David Geffen School of Medicine, University of California, Los Angeles, CA 90095 (United States); Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095 (United States)

    2014-10-10

    In a normal human life span, the heart beats about 2–3 billion times. Under diseased conditions, a heart may lose its normal rhythm and degenerate suddenly into much faster and irregular rhythms, called arrhythmias, which may lead to sudden death. The transition from a normal rhythm to an arrhythmia is a transition from regular electrical wave conduction to irregular or turbulent wave conduction in the heart, and thus this medical problem is also a problem of physics and mathematics. In the last century, clinical, experimental, and theoretical studies have shown that dynamical theories play fundamental roles in understanding the mechanisms of the genesis of the normal heart rhythm as well as lethal arrhythmias. In this article, we summarize in detail the nonlinear and stochastic dynamics occurring in the heart and their links to normal cardiac functions and arrhythmias, providing a holistic view through integrating dynamics from the molecular (microscopic) scale, to the organelle (mesoscopic) scale, to the cellular, tissue, and organ (macroscopic) scales. We discuss what existing problems and challenges are waiting to be solved and how multi-scale mathematical modeling and nonlinear dynamics may be helpful for solving these problems.

  20. Electrical Heart Defibrillation with Ion Channel Blockers

    Science.gov (United States)

    Feeney, Erin; Clark, Courtney; Puwal, Steffan

    Heart disease is the leading cause of mortality in the United States. Rotary electrical waves within heart muscle underlie electrical disorders of the heart termed fibrillation; their propagation and breakup leads to a complex distribution of electrical activation of the tissue (and of the ensuing mechanical contraction that comes from electrical activation). Successful heart defibrillation has, thus far, been limited to delivering large electrical shocks to activate the entire heart and reset its electrical activity. In theory, defibrillation of a system this nonlinear should be possible with small electrical perturbations (stimulations). A successful algorithm for such a low-energy defibrillator continues to elude researchers. We propose to examine in silica whether low-energy electrical stimulations can be combined with antiarrhythmic, ion channel-blocking drugs to achieve a higher rate of defibrillation and whether the antiarrhythmic drugs should be delivered before or after electrical stimulation has commenced. Progress toward a more successful, low-energy defibrillator will greatly minimize the adverse effects noted in defibrillation and will assist in the development of pediatric defibrillators.

  1. Nonlinear and stochastic dynamics in the heart

    International Nuclear Information System (INIS)

    In a normal human life span, the heart beats about 2–3 billion times. Under diseased conditions, a heart may lose its normal rhythm and degenerate suddenly into much faster and irregular rhythms, called arrhythmias, which may lead to sudden death. The transition from a normal rhythm to an arrhythmia is a transition from regular electrical wave conduction to irregular or turbulent wave conduction in the heart, and thus this medical problem is also a problem of physics and mathematics. In the last century, clinical, experimental, and theoretical studies have shown that dynamical theories play fundamental roles in understanding the mechanisms of the genesis of the normal heart rhythm as well as lethal arrhythmias. In this article, we summarize in detail the nonlinear and stochastic dynamics occurring in the heart and their links to normal cardiac functions and arrhythmias, providing a holistic view through integrating dynamics from the molecular (microscopic) scale, to the organelle (mesoscopic) scale, to the cellular, tissue, and organ (macroscopic) scales. We discuss what existing problems and challenges are waiting to be solved and how multi-scale mathematical modeling and nonlinear dynamics may be helpful for solving these problems

  2. Cardiac fluid dynamics anticipates heart adaptation.

    Science.gov (United States)

    Pedrizzetti, Gianni; Martiniello, Alfonso R; Bianchi, Valter; D'Onofrio, Antonio; Caso, Pio; Tonti, Giovanni

    2015-01-21

    Hemodynamic forces represent an epigenetic factor during heart development and are supposed to influence the pathology of the grown heart. Cardiac blood motion is characterized by a vortical dynamics, and it is common belief that the cardiac vortex has a role in disease progressions or regression. Here we provide a preliminary demonstration about the relevance of maladaptive intra-cardiac vortex dynamics in the geometrical adaptation of the dysfunctional heart. We employed an in vivo model of patients who present a stable normal heart function in virtue of the cardiac resynchronization therapy (CRT, bi-ventricular pace-maker) and who are expected to develop left ventricle remodeling if pace-maker was switched off. Intra-ventricular fluid dynamics is analyzed by echocardiography (Echo-PIV). Under normal conditions, the flow presents a longitudinal alignment of the intraventricular hemodynamic forces. When pacing is temporarily switched off, flow forces develop a misalignment hammering onto lateral walls, despite no other electro-mechanical change is noticed. Hemodynamic forces result to be the first event that evokes a physiological activity anticipating cardiac changes and could help in the prediction of longer term heart adaptations.

  3. Heart-on-a-chip based on stem cell biology.

    Science.gov (United States)

    Jastrzebska, Elzbieta; Tomecka, Ewelina; Jesion, Iwona

    2016-01-15

    Heart diseases are one of the main causes of death around the world. The great challenge for scientists is to develop new therapeutic methods for these types of ailments. Stem cells (SCs) therapy could be one of a promising technique used for renewal of cardiac cells and treatment of heart diseases. Conventional in vitro techniques utilized for investigation of heart regeneration do not mimic natural cardiac physiology. Lab-on-a-chip systems may be the solution which could allow the creation of a heart muscle model, enabling the growth of cardiac cells in conditions similar to in vivo conditions. Microsystems can be also used for differentiation of stem cells into heart cells, successfully. It will help better understand of proliferation and regeneration ability of these cells. In this review, we present Heart-on-a-chip systems based on cardiac cell culture and stem cell biology. This review begins with the description of the physiological environment and the functions of the heart. Next, we shortly described conventional techniques of stem cells differentiation into the cardiac cells. This review is mostly focused on describing Lab-on-a-chip systems for cardiac tissue engineering. Therefore, in the next part of this article, the microsystems for both cardiac cell culture and SCs differentiation into cardiac cells are described. The section about SCs differentiation into the heart cells is divided in sections describing biochemical, physical and mechanical stimulations. Finally, we outline present challenges and future research concerning Heart-on-a-chip based on stem cell biology.

  4. The heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Dümcke, Christine Winkler; Krag, Aleksander

    2009-01-01

    Cardiac failure affects the liver and liver dysfunction affects the heart. Chronic and acute heart failure can lead to cardiac cirrhosis and cardiogenic ischemic hepatitis. These conditions may impair liver function and treatment should be directed towards the primary heart disease and seek...... against the heart failure. Transjugular intrahepatic portosystemic shunt insertion and liver transplantation affect cardiac function in portal hypertensive patients and cause stress to the cirrhotic heart, with a risk of perioperative heart failure. The risk and prevalence of coronary artery disease...

  5. Changing Role of Heart Transplantation.

    Science.gov (United States)

    Kittleson, Michelle M

    2016-07-01

    Heart transplantation has become standard of care for end-stage heart failure. Challenges include the limited supply of donor organs and the increased complexity of heart transplant candidates who are at higher risk for poor outcomes. Recent advances may address these challenges, including proposed changes in heart transplant allocation policy, a better understanding of the definition and management of primary graft dysfunction, and advances in the management of sensitized heart transplant candidates. Developments in these areas may result in more equitable distribution and expansion of the donor pool and improved quality of life and survival for heart transplant recipients. PMID:27371517

  6. Race By Hearts

    DEFF Research Database (Denmark)

    Sonne, Tobias; Jensen, Mads Møller

    2014-01-01

    In this paper, we explore the qualities of sharing biometric data in re- al-time between athletes, in order to increase two motivational factors for gym- goers: Enjoyment and social interaction. We present a novel smartphone appli- cation, called Race By Hearts, which enables competition based...... on heart rate data sharing between users in real-time. Through an empirical study conducted in the gym, we show that sharing biometric data in real-time can strengthen so- cial relations between participants, increase motivation, and improve the en- joyment of the fitness activity. Nevertheless, we found...

  7. Desmame da ventilação mecânica utilizando pressão de suporte ou tubo T: comparação entre pacientes cardiopatas e não cardiopatas Weaning from mechanical ventilation by using pressure support or T-tube ventilation: comparison between patients with and without heart disease

    Directory of Open Access Journals (Sweden)

    Alexandre Doval da Costa

    2005-07-01

    Full Text Available OBJETIVO: Analisar variáveis cardiorrespiratórias durante o desmame com as técnicas tubo T e pressão de suporte e compará-las em grupos de cardiopatas e não cardiopatas. MÉTODOS: Avaliados 20 pacientes (57±15 anos quanto à: oxigenação, eliminação de CO2, freqüência respiratória e cardíaca, volume corrente e volume minuto, freqüência cardíaca, pressão arterial e alterações eletrocardiográficas. Os dados foram registrados, em ambas as técnicas, aos zero, 15 e 30 min, com intervalo de 30 min. Os pacientes foram divididos em cardiopatas (n=11 e não cardiopatas (n=9 e comparados. RESULTADOS: Comparando-se pressão de suporte com tubo T demonstraram-se: valores de oxigenação e eliminação de CO2 significativamente mais elevados e freqüência respiratória reduzidos. Não houve diferença quanto à pressão arterial e freqüência cardíaca. Comparando-se cardiopatas versus não cardiopatas, foram verificadas, respectivamente, alterações de segmento ST em 7 (64% versus 2 (22%, arritmias em 3 (27% versus 1 (11% e menor ocorrência de taquicardia. CONCLUSÃO: Na comparação de pressão de suporte com tubo T uma melhor resposta foi observada nas medidas de parâmetros respiratórios e de oxigenação com o uso de pressão de suporte, não havendo diferenças significativas nas medidas de parâmetros cardiovasculares. Houve menor ocorrência de taquicardia, maior ocorrência de alterações de segmento ST e tendência à maior ocorrência de arritmias nos cardiopatas, em ambos os modos de desmame.OBJECTIVE: To assess cardiorespiratory variables during weaning from mechanical ventilation by using the T-tube and pressure support techniques, and to compare them in groups of patients with and without heart disease. METHODS: To assess the following parameters of 20 patients (57±15 years undergoing weaning from mechanical ventilation: oxygenation; CO2 elimination; respiratory and heart rates; tidal and minute volumes; blood

  8. Arrhythmogenic remodelling of activation and repolarization in the failing human heart.

    Science.gov (United States)

    Holzem, Katherine M; Efimov, Igor R

    2012-11-01

    Heart failure is a major cause of disability and death worldwide, and approximately half of heart failure-related deaths are sudden and presumably due to ventricular arrhythmias. Patients with heart failure have been shown to be at 6- to 9-fold increased risk of sudden cardiac death compared to the general population. (AHA. Heart Disease and Stroke Statistics-2003 Update. Heart and Stroke Facts. Dallas, TX: American Heart Association; 2002) Thus, electrophysiological remodelling associated with heart failure is a leading cause of disease mortality and has been a major investigational focus examined using many animal models of heart failure. While these studies have provided an important foundation for understanding the arrhythmogenic pathophysiology of heart failure, the need for corroborating studies conducted on human heart tissue has been increasingly recognized. Many human heart studies of conduction and repolarization remodelling have now been published and shed some light on important, potentially arrhythmogenic, changes in human heart failure. These studies are being conducted at multiple experimental scales from isolated cells to whole-tissue preparations and have provided insight into regulatory mechanisms such as decreased protein expression, alternative mRNA splicing of ion channel genes, and defective cellular trafficking. Further investigations of heart failure in the human myocardium will be essential for determining possible therapeutic targets to prevent arrhythmia in heart failure and for facilitating the translation of basic research findings to the clinical realm.

  9. Heart failure association of the European society of cardiology specialist heart failure curriculum.

    Science.gov (United States)

    McDonagh, Theresa A; Gardner, Roy S; Lainscak, Mitja; Nielsen, Olav W; Parissis, John; Filippatos, Gerasimos; Anker, Stefan D

    2014-02-01

    It is well established that organized care of heart failure patients, including specialist management by cardiologists, improves patient outcomes. In response to this, other national training bodies (the UK and the USA) have developed heart failure subspecialty curricula within their Cardiology Training Curricula. In addition, European Society of Cardiology (ESC) subspecialty curricula exist for Interventional Cardiology and Heart Rhythm Management. The purpose of this heart failure curriculum is to provide a framework which can be used as a blueprint for training across Europe. This blueprint mirrors other ESC curricula. Each section has three components: the knowledge required, the skills which are necessary, and the professionalism (attitudes and behaviours) which should be attained. The programme is designed to last 2 years. The first year is devoted to the specialist heart failure module. The second year allows completion of the optional modules of advanced imaging, device therapy for implanters, cardiac transplantation, and mechanical circulatory support. The second year can also be devoted to continuation of specialist heart failure training and/or research for those not wishing to continue with the advanced modules.

  10. Heart Health: Learn the Truth About Your Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

  11. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  12. The Danish heart register

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Z; Madsen, Mette

    2011-01-01

    Introduction: The Danish Heart Register (DHR) is a clinical database of invasive procedures within cardiology. Content: All providers of these procedures have been obliged to report to DHR since 2000. DHR is used to monitor the activity and quality of the procedures and serves as a data source...

  13. Heart Disease and Stroke

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the number one killer in the United States - heart disease and stroke.  Created: 9/3/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/6/2014.

  14. Anthocyanins and heart disease

    Science.gov (United States)

    Anthocyanins are red, blue, and purple pigments distributed throughout nature, and in our diet. One potential health benefit of dietary anthocyanins is protection against cardiovascular disease (CVD). Evidence for beneficial effects of anthocyanins with respect to heart disease comes from epidemio...

  15. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  16. Caffeine and Heart Disease

    Science.gov (United States)

    ... American Heart area Search by State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) ... Smoking Tips for Friends and Family of Quitters Workplace Health Employer Resources Workplace Health Index Recognition & Awards ...

  17. Feedback on heart attack.

    Science.gov (United States)

    Pearce, Lynne

    2016-04-13

    The Royal Brompton & Harefield NHS Foundation Trust in London is the largest heart and lung centre in the UK. This article explores a project carried out by nurses at the trust looking at the experiences of having an acute myocardial infarction, and how patients felt about taking part in a research study. PMID:27532071

  18. Feedback on heart attack.

    Science.gov (United States)

    Pearce, Lynne

    2016-04-13

    The Royal Brompton & Harefield NHS Foundation Trust in London is the largest heart and lung centre in the UK. This article explores a project carried out by nurses at the trust looking at the experiences of having an acute myocardial infarction, and how patients felt about taking part in a research study.

  19. Congenital Heart Information Network

    Science.gov (United States)

    ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright ©1996 - 2016 C.H.I.N. All rights reserved TX4-390-685 Original site design and HTML by Panoptic Communications

  20. Heart Murmurs (For Kids)

    Science.gov (United States)

    ... flows through the heart. It sounds sort of like the noise of water flowing through a hose. This sound ... a stethoscope. The whoosh is just an extra noise that the blood makes as it ... they're sick. Just like kids, murmurs have grades. Grade 1 is the ...

  1. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... of Diabetes Educators JDRF American Heart Association MedlinePlus Diabetes Disease Organizations Many organizations provide support to patients ... Disease Organizations (PDF, 293 KB). Alternate Language URL Diabetes, Heart Disease, and Stroke Page Content On this ...

  2. Heart Failure Society of America

    Science.gov (United States)

    ... Site Terms and Conditions Copyright © 2016 Heart Failure Society of America. All Rights Reserved 2016 Board Review ... Membership Membership Information Membership in the Heart Failure Society is open to all health care professionals with ...

  3. Ejection Fraction Heart Failure Measurement

    Science.gov (United States)

    ... Tools & Resources Stroke More Ejection Fraction Heart Failure Measurement Updated:May 31,2016 The ejection fraction (EF) is an important measurement in determining how well your heart is pumping ...

  4. Heart Disease: Know Your Risk

    Science.gov (United States)

    ... and Stroke This information in Spanish ( en español ) Heart disease: Know your risk Are you at risk for ... risk factors Return to top More information on Heart disease and stroke prevention Read more from womenshealth.gov ...

  5. FastStats: Heart Disease

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Heart Disease Recommend on Facebook Tweet Share Compartir Data are ... the U.S. Morbidity Number of adults with diagnosed heart disease: 27.6 million Percent of adults with diagnosed ...

  6. Maintain a Heart Healthy Lifestyle

    Medline Plus

    Full Text Available ... attack. DR. BRUCE MacLEOD: The truth is that heart disease is the number one cause of death among women. And the risk of having a heart attack increases with age, especially after menopause. So ...

  7. How Is Heart Failure Treated?

    Science.gov (United States)

    ... your heart doesn’t work as hard to pump blood. Studies have shown that this medicine can reduce ... a left ventricular assist device . This device helps pump blood from the heart to the rest of the ...

  8. What Is Heart Valve Disease?

    Science.gov (United States)

    ... heart work harder and affect its ability to pump blood. Overview How the Heart Valves Work At the ... into the atria. As the ventricles contract, they pump blood through the pulmonary and aortic valves. The pulmonary ...

  9. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... or higher or Taking medication for elevated blood glucose levels Source: Grundy SM, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung,and Blood Institute Scientific Statement. Circulation. 2005;112: ...

  10. Give your heart a workout

    Science.gov (United States)

    ... JM, Ard JD, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ... risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ...

  11. Lyme Disease and the Heart

    Science.gov (United States)

    ... of the American Heart Association Cardiology Patient Page Lyme Disease and the Heart Peter J. Krause and Linda ... in a few cases. Diagnosis and Treatment of Lyme Disease The Centers for Disease Control and Prevention has ...

  12. Maintain a Heart Healthy Lifestyle

    Medline Plus

    Full Text Available ... activity. BOB WELTNER: My heart stopped and in theory, I guess I was dead. But through the ... The truth is that heart disease is the number one cause of death among women. And the ...

  13. Maintain a Heart Healthy Lifestyle

    Medline Plus

    Full Text Available ... is the number one cause of death among women. And the risk of having a heart attack ... age, especially after menopause. So it's essential that women become more aware of their heart health. JOAN ...

  14. Your Heart Failure Healthcare Team

    Science.gov (United States)

    ... Tools & Resources Stroke More Your Heart Failure Healthcare Team Updated:Mar 25,2016 Patients with heart failure ... good relationships with all the members of this team. Learn to talk to them openly and honestly ...

  15. Data and Statistics: Heart Failure

    Science.gov (United States)

    ... Program Funded States History of PCNASP PCNASP Metrics/Data Elements PCNASP Logic Model 2015 PCNASP FOA DP15- ... Insurance Million Hearts® Clinical Quality Measures (CQM) Dashboard Data Trends & Maps Printed Atlases Heart Disease Hospitalizations Among ...

  16. Maintain a Heart Healthy Lifestyle

    Medline Plus

    Full Text Available ... having a heart attack increases with age, especially after menopause. So it's essential that women become more ... so many people who experience heart attack symptoms, you might not be sure that you're having ...

  17. COMBINED HEART-KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2016-01-01

    Full Text Available Combined heart-kidney transplantation may be performed in carefully selected patients with end-stage heart disease and renal failure. There are two types of combined transplantation of heart and kidney: 1 simultaneous heart-kidney transplantation (SHKT from the same donor; 2 staged transplantation of heart and kidneys from two genetically different donors. The ISHLT registry in 2014 reported an increase in the number of SHKT over the years: from 22 in 1994 to 97 in 2012. World experience demonstrated excellent results of SHKT. Recipients of SHKT had superior survival, lower rates of acute cardiac and renal rejection compared to heart recipients. This article discusses the indications for simultaneous or staged heart-kidney transplantation in patients with dialysis-independent or dialysis-dependent renal failure, results and posttransplant survival of SHKT recipients. The author describes his own experience of 2 staged combined heart-kidney transplantations.

  18. Modelling heart rate kinetics.

    Directory of Open Access Journals (Sweden)

    Maria S Zakynthinaki

    Full Text Available The objective of the present study was to formulate a simple and at the same time effective mathematical model of heart rate kinetics in response to movement (exercise. Based on an existing model, a system of two coupled differential equations which give the rate of change of heart rate and the rate of change of exercise intensity is used. The modifications introduced to the existing model are justified and discussed in detail, while models of blood lactate accumulation in respect to time and exercise intensity are also presented. The main modification is that the proposed model has now only one parameter which reflects the overall cardiovascular condition of the individual. The time elapsed after the beginning of the exercise, the intensity of the exercise, as well as blood lactate are also taken into account. Application of the model provides information regarding the individual's cardiovascular condition and is able to detect possible changes in it, across the data recording periods. To demonstrate examples of successful numerical fit of the model, constant intensity experimental heart rate data sets of two individuals have been selected and numerical optimization was implemented. In addition, numerical simulations provided predictions for various exercise intensities and various cardiovascular condition levels. The proposed model can serve as a powerful tool for a complete means of heart rate analysis, not only in exercise physiology (for efficiently designing training sessions for healthy subjects but also in the areas of cardiovascular health and rehabilitation (including application in population groups for which direct heart rate recordings at intense exercises are not possible or not allowed, such as elderly or pregnant women.

  19. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  20. Epigenetics in heart failure phenotypes.

    Science.gov (United States)

    Berezin, Alexander

    2016-12-01

    Chronic heart failure (HF) is a leading clinical and public problem posing a higher risk of morbidity and mortality in different populations. HF appears to be in both phenotypic forms: HF with reduced left ventricular ejection fraction (HFrEF) and HF with preserved left ventricular ejection fraction (HFpEF). Although both HF phenotypes can be distinguished through clinical features, co-morbidity status, prediction score, and treatment, the clinical outcomes in patients with HFrEF and HFpEF are similar. In this context, investigation of various molecular and cellular mechanisms leading to the development and progression of both HF phenotypes is very important. There is emerging evidence that epigenetic regulation may have a clue in the pathogenesis of HF. This review represents current available evidence regarding the implication of epigenetic modifications in the development of different HF phenotypes and perspectives of epigenetic-based therapies of HF. PMID:27335803

  1. Longitudinal Imaging of Heart Development With Optical Coherence Tomography

    Science.gov (United States)

    Jenkins, Michael W.; Watanabe, Michiko; Rollins, Andrew M.

    2015-01-01

    Optical coherence tomography (OCT) has great potential for deciphering the role of mechanics in normal and abnormal heart development. OCT images tissue microstructure and blood flow deep into the tissue (1–2mm) at high spatiotemporal resolutions allowing unprecedented images of the developing heart. Here, we review the advancement of OCT technology to image heart development and report some of our recent findings utilizing OCT imaging under environmental control for longitudinal imaging. Precise control of the environment is absolutely required in longitudinal studies that follow the growth of the embryo or studies comparing normal versus perturbed heart development to obtain meaningful in vivo results. These types of studies are essential to tease out the influence of cardiac dynamics on molecular expression and their role in the progression of congenital heart defects. PMID:26236147

  2. Heart Transplantation (Beyond the Basics)

    Science.gov (United States)

    ... providers must strictly evaluate who should receive a heart transplant. REASONS FOR HEART TRANSPLANTATION — The American Society of ... including transplant professionals, recipients, and donor families. PRE-HEART TRANSPLANT EVALUATION — People who meet VO2 and/or other ...

  3. Other Possible Heart Disease Risk Factors

    Science.gov (United States)

    ... your risk Heart Health and Stroke Other possible heart disease risk factors Related information Depression fact sheet Stress ... Return to top More information on Other possible heart disease risk factors Read more from womenshealth.gov Heart ...

  4. Heart Disease Affects Women of All Ages

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter ... weeks of a heart attack. For Women with Heart Disease: About 6 million American women have coronary heart ...

  5. How Is a Heart Attack Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is a Heart Attack Treated? Early treatment for a heart attack can ... or years after the procedure. Other Treatments for Heart Attack Other treatments for heart attack include: Medicines Medical ...

  6. How Is a Heart Attack Diagnosed?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is a Heart Attack Diagnosed? Your doctor will diagnose a heart attack ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  7. What Are the Risks of Heart Transplant?

    Science.gov (United States)

    ... on Twitter. What Are the Risks of a Heart Transplant? Although heart transplant surgery is a life-saving measure, it has ... of these risks. The risks of having a heart transplant include: Failure of the donor heart Complications from ...

  8. What to Expect during a Heart Transplant

    Science.gov (United States)

    ... NHLBI on Twitter. What To Expect During a Heart Transplant Just before heart transplant surgery, the patient will ... are not replaced as part of the surgery. Heart Transplant Figure A shows where the diseased heart is ...

  9. How Is Heart Valve Disease Treated?

    Science.gov (United States)

    ... is called a valve-in-valve procedure. Heart-Healthy Lifestyle Changes to Treat Other Related Heart Conditions To ... your doctor may advise you to make heart-healthy lifestyle changes, such as: Heart-healthy eating Aiming for ...

  10. What Is a Nuclear Heart Scan?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is a Nuclear Heart Scan? A nuclear heart scan is a test that provides important ... use it to create pictures of your heart. Nuclear heart scans are used for three main purposes: ...

  11. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease. PMID:27226153

  12. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease.

  13. Clinical Pharmacists' Experience about the Practice of Anticoagulation Management of the Patients Who Had Been Discharged from Hospital after Undergoing Mechanical Heart Valve Replacement%临床药师参与心脏机械瓣膜置换术患者出院后抗凝管理的实践与体会

    Institute of Scientific and Technical Information of China (English)

    张海燕; 罗万慰; 马守梅

    2009-01-01

    To explore the function and approach of clinical pharmacists' participating in the anticoagulation management of patients who had been discharged from hospital after undergoing mechanical heart valve replacement. METHODS: The experiences of clinical pharmacists obtained through first-hand practice in the anticoagulation management and pharmaceutical care of the patients who had been discharged from hospital after undergoing mechanical heart valve replacement were introduced by illustrating examples. RESULTS & CONCLUSION: Clinical pharmacists' participating in the anticoagulation management of patients who had been discharged from hospital after undergoing mechanical heart valve replacement provide physicians and patients with pharmaceutical information and pharmaceutical care and enhance the effectiveness and safety of anticoagulative therapy accordingly.%目的:探讨临床药师参与心脏机械瓣膜置换术患者出院后抗凝治疗管理的作用和方法.方法:通过亲身实践,介绍我院临床药师参与抗凝管理工作及开展药学服务的体会,并结合典型实例分析说明.结果与结论:临床药师通过参与心脏机械瓣膜置换术患者出院后的抗凝管理工作,为医师及患者提供药学信息和药学服务,可提高抗凝治疗的安全性和有效性.

  14. Influence of diabetes mellitus on heart failure risk and outcome

    Directory of Open Access Journals (Sweden)

    Van Belle Eric

    2003-01-01

    Full Text Available Abstract Our aim is to summarize and discuss the recent literature linking diabetes mellitus with heart failure, and to address the issue of the optimal treatment for diabetic patients with heart failure. The studies linking diabetes mellitus (DM with heart failure (HF The prevalence of diabetes mellitus in heart failure populations is close to 20% compared with 4 to 6% in control populations. Epidemiological studies have demonstrated an increased risk of heart failure in diabetics; moreover, in diabetic populations, poor glycemic control has been associated with an increased risk of heart failure. Various mechanisms may link diabetes mellitus to heart failure: firstly, associated comorbidities such as hypertension may play a role; secondly, diabetes accelerates the development of coronary atherosclerosis; thirdly, experimental and clinical studies support the existence of a specific diabetic cardiomyopathy related to microangiopathy, metabolic factors or myocardial fibrosis. Subgroup analyses of randomized trials demonstrate that diabetes is also an important prognostic factor in heart failure. In addition, it has been suggested that the deleterious impact of diabetes may be especially marked in patients with ischemic cardiomyopathy. Treatment of heart failure in diabetic patients The knowledge of the diabetic status may help to define the optimal therapeutic strategy for heart failure patients. Cornerstone treatments such as ACE inhibitors or beta-blockers appear to be uniformly beneficial in diabetic and non diabetic populations. However, in ischemic cardiomyopathy, the choice of the revascularization technique may differ according to diabetic status. Finally, clinical studies are needed to determine whether improved metabolic control might favorably influence the outcome of diabetic heart failure patients.

  15. Parkin-dependent mitophagy in the heart.

    Science.gov (United States)

    Dorn, Gerald W

    2016-06-01

    Mitochondria can undergo autophagic elimination for differing reasons, e.g. as part of a cell-wide macroautophagic response, as part of mitochondrial turnover during metabolic remodeling, or in the case of selective mitophagic destruction of dysfunctional mitochondria, during mitochondrial quality control. Multiple mechanistically distinct pathways converge upon, and activate, mitochondrial autophagy. Here, the evidence supporting a role for the prototypical mitochondrial quality control pathway, PINK1-Parkin mediated mitophagy, in cardiac homeostasis and heart disease is reviewed. Contrary to popular wisdom based on findings from non-cardiac systems, current data do not support a major role for Parkin-mediated mitophagy as a mechanism for constitutive mitochondrial housekeeping, and instead suggest that this pathway primarily functions in adult hearts as an inducible cardiac stress-response mechanism. Recent findings have also uncovered an unsuspected role for Parkin-mediated mitochondrial turnover in the normal perinatal transformation of myocardial metabolism. PMID:26611886

  16. Three decades of heart transplantation in Scandinavia

    DEFF Research Database (Denmark)

    Dellgren, Göran; Geiran, Odd; Lemström, Karl;

    2012-01-01

    years of follow-up, respectively. Ten-year survival in patients bridged with mechanical circulatory support, in children, after retransplantation, and after concomitant other organ transplantation was 56, 74, 38, and 43%, respectively. Older patients (age >55 years) had a significantly worse survival (P.......001). CONCLUSIONS: HTx in Scandinavia proves to have a significantly better survival among patients transplanted in the last decade. HTxs from mechanical circulatory support, in children, after retransplantation, and with concomitant other organ transplantation were performed with acceptable results.......AimHeart transplantation (HTx) has become a standard treatment for patients with end-stage heart disease. The aim of this study was to report the long-term outcome after HTx in Scandinavia. METHODS AND RESULTS: During the period, 1983-2009, 2333 HTxs were performed in 2293 patients (mean age 45...

  17. Migration paths of cells different origins in the embryonic human heart

    OpenAIRE

    Voloshin N. A.; Chaykovsky Yu. B.

    2010-01-01

    Hearts of human embryos were investigated using immunohistochemical method with antibodies to neurofilaments from 4 to 8 week of prenatal development. It was found that the embryonic human heart there are NF-positive cells, which occupy its territory by two mechanisms: through the migration of intercellular spaces and on the mechanism immersion out of heart cavity. In the second case neurofilaments-positive cells through the endothelium of blood vessels or endocardium immersion into the myoca...

  18. Cardioprotective effects of morphine on rat heart suffering from ischemia and reperfusion

    Institute of Scientific and Technical Information of China (English)

    师恩祎; 江晓菁; 白菡; 谷天祥; 常业恬; 王俊科

    2003-01-01

    Objective To investigate the cardioprotective effects of morphine on ischemic reperfused rat heart in vitro and its mechanism.Methods The isolated rat heart was perfused in a Langendorff apparatus. Infarct myocardium was determined by TTC. Coronary flow (CF), heart rate (HR), left ventricular pressure (LVP), the first derivative of ventricular pressure (LVP/dtmax) and infarct size after ischemia and reperfusion in rat heart given 0.3 μmol/L morphine were observed. The effects of naloxone and glibenclamide on the cardioprotection of morphine were also measured.Results After ischemia and reperfusion, CF, HR, LVP and LVP/dtmax of isolated rat hearts decreased significantly (P0.05). The cardioprotective effects of morphine were abolished by naloxone or glibenclamide completely.Conclusions Morphine can reduce ischemia-reperfusion injuries in isolated rat heart. The cardioprotective effects of morphine are mediated by a local opioid receptor-KATP channel linked mechanism in rat hearts.

  19. Copeptin in heart failure

    Directory of Open Access Journals (Sweden)

    Lasota B

    2014-07-01

    Full Text Available Bartosz Lasota,1 Katarzyna Mizia-Stec212nd Department of Cardiology, Medical University of Silesia, Katowice, Poland; 21st Department of Cardiology, Medical University of Silesia, Katowice, PolandAbstract: Copeptin is a novel indicator of arginine–vasopressin activation in the body. Its value has primarily been documented in acute life-threatening conditions mediated by the stress response system. Recently, some studies have revealed copeptin's promising role as a marker in cardiovascular diseases. In our review, we summarize the current knowledge on copeptin in pathophysiology, as well as in risk assessment in different clinical settings involving the cardiovascular system with a special focus on heart failure.Keywords: copeptin, heart failure, arginine–vasopressin

  20. The Heart of Matter

    CERN Document Server

    Godbole, Rohini M

    2010-01-01

    In this article I trace the development of the human understanding of the "Heart of Matter" from early concepts of "elements" (or alternatively "Panchmahabhootas") to the current status of "quarks" and "leptons" as the fundamental constituents of matter, interacting together via exchange of the various force carrier particles called "gauge bosons" such as the photon, W/Z-boson etc. I would like to show how our understanding of the fundamental constituents of matter has gone hand in hand with our understanding of the fundamental forces in nature. I will also outline how the knowledge of particle physics at the "micro" scale of less than a Fermi(one millionth of a nanometer), enables us to offer explanations of Cosmological observations at the "macro" scale. Consequently these observations, may in turn, help us address some very fundamental questions of the Physics at the "Heart of the Matter".