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Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Atherosclerosis in CAD often has distribution in different vessels that is highly irregular. It occurs most at vessel bifurcations or other areas of turbulence. With growth of atheromatous plaques, the arterial lumen becomes progressively narrowed, and ischemia develops. This often causes angina pectoris. The amount of stenosis that will cause ischemia is different with varying oxygen demands. Sometimes an atheromatous plaque splits or ruptures, likely due to morphology, calcium content, or plaque softening because of an inflammatory condition. An acute thrombus is formed, interrupting coronary blood flow. Acute coronary syndromes, including acute ischemia, are based on the degree of obstruction and its location. A transmural infarction can occur. Additional complications include conduction defects, ventricular arrhythmias, heart failure, and sudden death.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Heart failure is a complex clinical syndrome of symptoms including breathlessness, ankle oedema and fatigue, suggesting there is impairment of the heart working effectively as a pump to support the circulation (ESC 2016a). The heart therefore is unable to adequately perfuse the organs and tissues of the body. The term heart failure should not be confused with cardiac arrest (which is an emergency situation), or ‘heart attack’ (which normally refers to myocardial infarction). Increases in survival from the chronic diseases that contribute to heart failure has added to the number of people in the UK living with the disease, with a recent increase (2002–2014) of around 23% (Conrad et al. 2017). Common causes of heart failure include ischaemic heart disease, hypertension, heart valve disease and other structural changes to the myocardium (such as cardiomyopathy). Structural changes to the heart occur before symptoms are apparent, so considering risk and treating patients early contributes to a reduced reduce mortality.
Drug management
Published in Gregory YH Lip, Atrial Fibrillation in Practice, 2020
The treatment of heart failure is well established with evidence for the use of diuretics, angiotensin-converting enzyme inhibitors, beta-blockers, digoxin and spironolactone. As previously stated, AF and heart failure commonly co-exist and so inevitably trials of various treatments for heart failure have included patients with AF. No evidence was found that sub-groups of patients with concurrent heart failure and AF do not benefit from the validated treatments for heart failure listed.
Significant discordance between point of care BNP values obtained by the i-STAT and the Beckman DXI 800, causing confusion in patient management when both methods are used interchangeably by clinicians
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2023
Kristine Zinn, Mercedes Boyd, Amitava Dasgupta
Heart failure is due to the inability of the heart to pump enough blood and oxygen to various organs to support their metabolic demands for adequate physiological functions. Heart failure is associated with significant morbidity and mortality. It has been estimated that approximately 64 million people worldwide suffer from heart failure [1]. Circulating biomarkers reflecting pathophysiological pathways involved in the development and progression of heart failure could assist clinicians in early diagnosis and management. Natriuretic peptides such as B-type natriuretic peptide (BNP) and NT-proBNP (both derived from a pre-hormone with 134 amino acids encoded by NPPB gene) are recognized as useful biomarkers for heart failure. The pre-hormone breaks down into BNP1–108 due to the loss of a 26 amino acid residue. This molecule is further cleaved by enzymes into BNP1–32, the biologically active molecule, and NT-proBNP1–76, its inactive N-terminal fragment. American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend the use of BNP and NT-proBNP for the diagnosis of heart failure. Usually, a BNP concentration <100 ng/L is considered normal [2].
Calanus oil attenuates isoproterenol-induced cardiac hypertrophy by regulating myocardial remodeling and oxidative stress
Published in Ultrastructural Pathology, 2023
Shrook Y. Abdellatif, Nagui H. Fares, Samar H. Elsharkawy, Yomna I. Mahmoud
Cardiac hypertrophy (CH) is an adaptive and compensatory response of the heart to preserve cardiac function during persistent increased workload. During this response, the cardiomyocytes change their shape, increase in size, and remodel the extracellular matrix (ECM),1 which leads to the hallmarks of cardiac hypertrophy: thickening of the interventricular septum and concentric left ventricular hypertrophy.2 However, sustained concentric hypertrophy constitutes a risk factor of heart failure and sudden death.1 Treatment strategies for heart failure commonly include diuretics, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and β-blockers; however, mortality rates remain high. Current CH pharmacotherapies such as diuretics, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and β-blockers, significantly delay the onset of heart failure, but they have many adverse effects,3 and limited success to restore the quality of life,4 and mortality rates remain high.3 Hence, there is a pressing need to explore novel strategies and therapeutic interventions to prevent ECM remodeling and CH symptoms, with lower side effects.
Heart failure is associated with accelerated age related metabolic bone disease
Published in Acta Cardiologica, 2021
Pieter Martens, Jozine M. ter Maaten, Dimitri Vanhaen, Ellen Heeren, Thalissa Caers, Becky Bovens, Jeroen Dauw, Matthias Dupont, Wilfried Mullens
This study is a case-control analysis performed in the ‘Ziekenhuis Oost Limburg’ (ZOL Genk, Belgium). All patients who underwent a DEXA scan between January 2008 and January 2019, were extracted from the electronic hospital medical record (see Figure 1). Second or third DEXA-scans were excluded to generate an unique patient dataset. The DEXA-scan dataset was crossed-matched with a prospective heart failure patient database from the ZOL-Genk heart failure clinic, hereby identifying heart failure patients (cases) for the case-control analysis. The ZOL-Genk database is a prospective database in which all newly diagnosed heart failure patients are registered for further follow-up in a tertiary heart failure clinic. Diagnosis of heart failure were made by experienced heart failure specialist according to established guideline criteria [10]. Based on the age and gender of the heart failure cases, a random 2:1 matching was performed of the remaining patients in the DEXA-dataset for the selection of controls. Baseline characteristics, physical features, laboratory features, cardiovascular medications and osteoporosis related medications at the time of the DEXA-scan were retrospectively collected from the medical health record.