Результаты поиска

Alcohol septal ablation for left ventricular outflow tract obstruction in cardiac amyloidosis: New indication for an established therapy.

Cardiac amyloidosis can occasionally demonstrate an atypical pattern of infiltration, causing asymmetric septal thickening and a left ventricular outflow tract (LVOT) gradient with systolic anterior motion (SAM) of the mitral valve resembling obstructive hypertrophic cardiomyopathy. We present a case of a 70-year-old man with cardiac light-chain amyloidosis and LVOT obstruction successfully treated with alcohol septal ablation (ASA). Following the procedure, he reported significant improvement in his heart failure symptoms as well as improvement in LVOT gradient and SAM of the mitral valve. Th

Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hypertension of over 180/110 or associated target organ damage, should

Cancer treatment-related cardiotoxicity, molecular mechanism, challenges, and research trends.

Cancer treatment-related cardiotoxicity (CTRC) encompasses a spectrum of cardiovascular complications associated with chemotherapy, targeted therapy, and radiotherapy. This review synthesizes recent mechanistic insights to delineate distinct pathological pathways: anthracyclines provoke oxidative mitochondrial damage and disrupt cardiomyocyte iron homeostasis; HER2-targeted therapies inhibit the PI3K-Akt survival pathway, compromising contractile function and calcium regulation; tyrosine kinase inhibitors impair VEGF and PDGF signaling, inducing endothelial dysfunction and microvascular rarefa

Совпадение в полном тексте источника
… Promising tools for risk stratification and treatment guidance include circulating biomarkers [ 28 , 29 ], advanced imaging techniques [ 30 ], and genetic profiling [ 31 ] Despite these advances, CTRC management remains complex and necessitates close multidisciplinary collaboration among oncologists, cardiologists … This approach necessitates strengthened collaboration between oncologists and cardiologists through integrated clinical decision-making [ 3 , 85 ]. Future trends and research prospects The evolving landscape of cancer therapy demands equally advanced strategies to manage cardiotoxicity. …

How I approach optimization of patients at risk of cardiac and pulmonary complications after CAR T-cell therapy.

Chimeric antigen receptor (CAR) T cells have transformed the care for patients with hematologic malignancies. Patients treated with CAR T cells may experience cardiovascular and pulmonary complications, which primarily occur in the setting of cytokine release syndrome. In addition, many patients considered for CAR T-cell therapy have preexisting cardiac and pulmonary comorbidities. Among patients with good functional status, these conditions should not prevent patients from being offered these lifesaving therapies. In this article, we use a case-based approach to discuss how we evaluate and op

Light Chain (AL) Amyloidosis: The Journey to Diagnosis.

BackgroundLight chain (AL) amyloidosis is a rare, complex disease associated with significant morbidity and mortality. Delays in diagnosis are common and may have detrimental consequences on patients' prognosis. Too little is known regarding the patient journey to diagnosis.ObjectiveThe objective of this study was to describe the patient-reported journey to a correct diagnosis for AL amyloidosis.MethodsUsing a mixed-methods approach, data were collected from clinician (n = 4) and patient (n = 10) interviews and a survey of community-based patients with AL amyloidosis (n = 341). Data were used

Совпадение в полном тексте источника
… As described in Table 4 , the types of specialty consultations depended on the patients’ organ involvement and included primary care physicians, cardiologists, hematologists, nephrologists, gastroenterologists, pulmonologists, and others. … Table 4 Types of specialists consulted prior to diagnosis among patient interviewees, by organ involvement Patient a Organ involvement Physician specialists consulted Cardiologist Gastroenterologist Hematologist Nephrologist Oncologist Primary care physician Pulmonology Other 001 K ✓ ✓ ✓ ✓ 002 K ✓ ✓ …

Onco-Cardiology: Consensus Paper of the German Cardiac Society, the German Society for Pediatric Cardiology and Congenital Heart Defects and the German Society for Hematology and Medical Oncology.

The acute and long-lasting side effects of modern multimodal tumour therapy significantly impair quality of life and survival of patients afflicted with malignancies. The key components of this therapy include radiotherapy, conventional chemotherapy, immunotherapy and targeted therapies. In addition to established tumour therapy strategies, up to 30 new therapies are approved each year with only incompletely characterised side effects. This consensus paper discusses the risk factors that contribute to the development of a potentially adverse reaction to tumour therapy and, in addition, defines

Совпадение в полном тексте источника
… Rotations on a ward with a focus on haematology or oncology as part of a specialised onco-cardiology section/team for cardiologists who want to focus more extensively in onco-cardiology is desirable for any later. … Toxicity of cancer therapy: what the cardiologist needs to know about angiogenesis inhibitors. Heart. 2018;104:1995–2002. doi: 10.1136/heartjnl-2018-313726. 38. Doherty KR, Wappel RL, Talbert DR, et al. …

Diagnosis and referral of patients with AL amyloidosis in Portugal: results from a Delphi panel.

Light chain amyloidosis (AL) is a complex disorder defined by the extracellular deposition of insoluble amyloid fibrils formed by intact or fragmented immunoglobulin light chains, leading to cell dysfunction, rapid organ deterioration, and, ultimately, death. Although the clinical presentation of AL is directly connected to organ involvement, signs and symptoms of AL are frequently nonspecific, misinterpreted, and late recognized. Thus, an early diagnosis combined with effective therapies to cease disease progression and rescue organ function is essential. The aim of this study was to assess t

Совпадение в полном тексте источника
… A diverse group of national health professionals, including cardiologists, hematologists, general practitioners, internists, nephrologists, and neurologists, were invited by their respective national specialty societies and/or by the external vendor to voluntarily participate by responding anonymously … Results This one-round Delphi-like panel included 108 physicians: 36 (33.4%) hematologists, 32 (29.6%) nephrologists, 17 (15.7%) general practitioners, 10 (9.3%) internists, 7 (6.5%) cardiologists, and 6 (5.5%) neurologists. …

Cardiac Amyloidosis: A Narrative Review of Diagnostic Advances and Emerging Therapies.

Background/Objectives: Cardiac amyloidosis (CA) is an underdiagnosed and potentially life-threatening infiltrative cardiomyopathy characterized by the extracellular deposition of misfolded amyloid fibrils in cardiac tissue. It is most commonly associated with light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis, either hereditary or wild-type. The disease often presents with non-specific symptoms, leading to delayed diagnosis and treatment. This study aims to provide a comprehensive overview of the pathophysiology, diagnostic strategies, and current therapeutic approaches for card

Совпадение в полном тексте источника
… Heightened clinical suspicion in high-risk populations, improved access to advanced imaging, and multidisciplinary collaboration between cardiologists, hematologists, and imaging specialists are essential. … Cardiac Amyloidosis Red Flags: What All the Cardiologist Have to Know Int. J. Cardiol. Cardiovasc. Risk Prev. 2024 21 200271 10.1016/j.ijcrp.2024.200271 39118988 PMC11305997 42. Debonnaire P. Claeys M. Smet M.D. Trenson S. Lycke M. Demeester C. Droogenbroeck J.V. Vriese A.S.D. Verhoeven K. …

A 57-Year-Old Female Presenting With Cardiopulmonary Arrest Secondary to Severe Hypokalemia From a Fanconi-Like Syndrome: A Case Report.

Fanconi syndrome is a multi-factorial disorder that involves diffuse malfunction of the proximal convoluted tubule in the kidney. Renal wasting of potassium, glucose, bicarbonate, amino acids, and phosphorus characterize the condition. We report a case of a 57-year-old female who presented to our emergency department with cardiopulmonary arrest. After successful resuscitation, she had extensive workup to uncover the cause of her cardiac arrest. She had extensive negative workup but was found to have severely low potassium, prompting further evaluation. She was noted to have elevated urine pota

Совпадение в полном тексте источника
… Therefore, this condition often necessitates a multidisciplinary approach, including the involvement of nephrologists, endocrinologists, and cardiologists in order to navigate the complex diagnostic process successfully. … Effective interventions require a multidisciplinary approach that includes emergency physicians, internists, nephrologists, and cardiologists, as well as clinical pharmacists. It is important to address and investigate the underlying causes of severe hypokalemia once the patient has stabilized. …

CardioMEMS guided heart failure management in cardio-oncology patients: a tertiary care cancer center experience.

AimsCancer patients and survivors are at increased risk of developing heart failure (HF) and heart failure hospitalization (HFH). Yet, the utilization of wireless pulmonary artery pressure sensing devices (PAPSD), like CardioMEMS, in this group is limited.ObjectivesWe aimed to explore the utilization of CardioMEMS in managing HF among oncology patients.MethodsWe conducted a single-center retrospective study reviewing consecutive patients implanted with the CardioMEMS device between November 11, 2015, and February 21, 2023. We analyzed the device's impact on pulmonary artery pressures and HFH u

Совпадение в полном тексте источника
… These reviews were conducted by trained advanced practice providers familiar with each patient’s clinical course, in collaboration with the supervising cardiologist. Titration decisions were individualized according to target PAD, renal function, age, and other comorbidities . … AL Amyloidosis for Cardiologists: Awareness, Diagnosis, and Future Prospects: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol. 2022;4:427–41. 31. Thohan V, Abraham J, Burdorf A, et al. Use of a Pulmonary Artery Pressure Sensor to Manage Patients With Left Ventricular Assist Devices. …

Transthyretin Amyloid Cardiomyopathy Risk Evaluation in a Cohort of Patients With Heart Failure.

Introduction Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, infiltrative form of heart failure (HF). Nevertheless, ATTR-CM is a largely underrecognized and misdiagnosed condition. This study's objective was to develop an efficient model to assess the chance of ATTR-CM in patients with HF. Methods This was an observational study of patients with HF who had a confirmed diagnosis of ATTR-CM and those with HF but without known ATTR-CM between January 1, 2019, and July 1, 2021. Patient characteristics were extracted from administrative and claims electronic databases and compared

Safety and Feasibility of Transcatheter Aortic Valve Replacement in Patients With Hematologic Neoplasms.

For patients with severe, symptomatic aortic stenosis (AS) who are poor surgical candidates, transcatheter aortic valve replacement (TAVR) offers a less invasive alternative to surgical valve replacement. Patients with hematologic neoplasms and severe AS are a high-risk subset, with increased risk of bleeding and infection, who have historically been excluded from clinical investigation in TAVR. Prior case reports have demonstrated successful TAVR in patients with hematologic neoplasms; however, there remains minimal literature on TAVR in this population. We present a series of 10 patients wit

Совпадение в полном тексте источника
… In addition, follow-up duration varied substantially (median 13.5 months), as many patients were referred for TAVR and then returned to local cardiologists after routine 1 year post-TAVR follow-up, limiting uniform long-term outcome assessment. … How risky is transcather aortic valve replacement in cancer patients with aortic stenosis: an onco-cardiologist dilemma J Am Coll Cardiol 83 13 2024 3363 10.1016/s0735-1097(24)05353-1 5 Aksoy H. Okutucu S. Sayın B.Y. Oto M.A. …

Neurocardiology Update: The Brain-Heart Connection in Multiple Sclerosis-A Narrative Review.

BACKGROUND AND AIMS: While multiple sclerosis (MS) is primarily considered a neurological disorder, mounting evidence suggests a strong association with cardiovascular diseases (CVDs), impacting both disease progression and patient outcomes. This paper aims to raise awareness of this disease association while promoting a clinical-oriented, multidisciplinary approach that can provide long-term benefits for these patients. METHODS: A comprehensive literature review was conducted to gather up-to-date evidence concerning the incidence and type of CVDs associated with MS, the mechanisms underlying

Совпадение в полном тексте источника
… In this paper, we highlight this interplay's relevance to neurologists and cardiologists and emphasize novel approaches readily available for inclusion in routine clinical practice. … A multidisciplinary team, including a cardiologist, should coordinate the whole process. Nevertheless, we acknowledge that further research is required to establish the cost‐effectiveness of such protocols in clinical practice. …

Cardiac Amyloidosis: Tribulations and New Frontiers.

This review article aims to provide an overview of the pathophysiology, diagnosis, and contemporary management of cardiac amyloidosis (CA) as well as identify the knowledge gaps and areas of potential research. CA can be divided into two main groups: transthyretin cardiac amyloidosis (ATTR-CA) and light chain cardiac amyloidosis (AL-CA). The former further separates into wild-type transthyretin (ATTRwt) and hereditary transthyretin (ATTRv). African Americans, males, and people older than 75 are the most common demographics affected by this disease. Thanks to an increased understanding of this

Совпадение в полном тексте источника
… Many of these patients report seeing more than two cardiologists before being diagnosed correctly [ 30 ]. Delays in diagnosis as well as multiple clinic visits without definitive answers can be frustrating to both patients and providers alike. 3.1. … Overview of Diagnostic Modalities The electrocardiogram (EKG) is one of the most ubiquitous diagnostic tools available to cardiologists. …

When and how do patients with cardiac amyloidosis die?

BackgroundCardiac amyloidosis (CA) is an underappreciated cause of morbidity and mortality. Light-chain (AL) and transthyretin (ATTR) amyloidosis have different disease trajectories. No data are available on subtype-specific modes of death (MOD) in patients with CA.Methods and resultsWe retrospectively investigated 66 with AL and 48 with wild-type ATTR amyloidosis (ATTRwt) from 2000 to 2018. ATTRwt differed from AL by age (74.6 ± 5.4 years vs. 63 ± 10.8 years), posterior wall thickness (16.8 ± 3.3 mm vs. 14.3 ± 2.2 mm), left ventricular mass index (180.7 ± 63.2 g/m2 vs. 133.5 ± 42.2 g/m2), and

Совпадение в полном тексте источника
… All deaths were adjudicated by two senior cardiologists (C. E. and G. P.). We employed a classification system derived from the “ACME system” for death in heart failure [ 23 ]. Mode of death (MOD) was first categorized as cardiovascular (CV) or non-cardiovascular (non-CV). … This underscores even more the cardiologists’ responsibilities with regard to early and exact diagnosis as well as comprehensive disease management strategies. …

A recommended practical approach to the management of target therapy and angiogenesis inhibitors cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology.

The US National Cancer Institute estimates that cardiotoxicity (CTX) from target therapy refers mostly to four groups of drugs: epidermal growth factor receptor 2 inhibitors, angiogenic inhibitors, directed Abelson murine leukemia viral oncogene homolog inhibitors, and proteasome inhibitors. The main cardiotoxic side-effects related to antiepidermal growth factor receptor 2 therapy are left ventricular systolic dysfunction and heart failure. Angiogenesis inhibitors are associated with hypertension, left ventricular dysfunction/heart failure, myocardial ischemia, QT prolongation, and thrombosis

Совпадение в полном тексте источника
… ACE inhibitors, angiotensin receptor blockers (ARBs), and β-blockers]. 3 , 23 , 24 Patients who are not eligible to start trastuzumab treatment for low ejection fraction should begin ACE inhibitors or ARB and β-blockers, and should be referred to a cardiologist 25 , 26 (Table 2 ). … Eur J Heart Fail 2013 ; 15 : 482 – 489 . 23325019 10.1093/eurjhf/hft008 40 Ederhy S Izzedine H Massard C Cardiac side effects of molecular targeted therapies: towards a better dialogue between oncologists and cardiologists . …

Case Report: AL Amyloidosis Severe Restrictive Cardiomyopathy Associated With Multiple Myeloma-Diagnostic Difficulties.

BackgroundCardiac AL amyloidosis as a complication of multiple myeloma (MM) is a formidable life-threatening condition. The first-line therapy for both MM and systemic AL amyloidosis is proteasome inhibitors (PIs). Unfortunately, the use of PIs may lead to cardiovascular toxicity development, which requires specific cardio-oncology supervision.Case reportA 57-year-old woman was admitted to a university hospital with clinical manifestation of progressive chronic heart failure. The patient had hypertension and no history of diabetes mellitus, myocardial infarction (MI), stroke, and arrhythmias.

ESCP Spring Workshop 2023: Advancing clinical pharmacy and care in diabetes and cardiovascular comorbidities-Antwerp, 20-21 April 2023.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Совпадение в полном тексте источника
… Low risk patients on oral anticoagulation and all moderate-high risk patients were discussed with cardiologists for antithrombotic therapy optimisation. … From the 88 (64%) patients discussed with cardiologists, the score was considered in 37 of them, and short-term DAPT was prescribed. The remaining patients were prescribed long-term (66%) or short-term (7%) DAPT irrespective of score. …

How do Internal Medicine Residents from Different Backgrounds Make Subspecialty Career Choices? A Qualitative Analysis.

PurposeMedical career decisions are complex. Gender and racial disparities remain among internal medicine (IM) subspecialty fellows, particularly in procedural subspecialties. This qualitative study aims to thematically explore factors that influence IM resident subspecialty career choice, with a focus on factors specific to women and UIM trainees to better understand existing disparities. This is the first study to explore IM residents own stated reasons to subspecialize into various fields.MethodsWe conducted virtual focus groups with 37 IM residents from multiple institutions, organized by

Efficacy of phosphodiesterase type 5 inhibitors in univentricular congenital heart disease: the SV-INHIBITION study design.

AIMS: In univentricular hearts, selective lung vasodilators such as phosphodiesterase type 5 (PDE5) inhibitors would decrease pulmonary resistance and improve exercise tolerance. However, the level of evidence for the use of PDE5 inhibitors in patients with a single ventricle (SV) remains limited. We present the SV-INHIBITION study rationale, design, and methods. METHODS AND RESULTS: The SV-INHIBITION trial is a nationwide multicentre, randomized, double blind, placebo-controlled, Phase III study, aiming to evaluate the efficacy of sildenafil on the ventilatory efficiency during exercise, in

Совпадение в полном тексте источника
… These investigators are paediatric cardiologists ( n = 18), adult congenital cardiologists ( n = 6), or both ( n = 12). …