J B Young

..To quantify the impact of bariatric surgery on cardiovascular (CV) risk factors, and on cardiac structure and function...

..The authors argue that this model better focuses on the patient as well as on the institution's academic charge. It is a concept that should be more widely adopted with deference to individual institutional culture and history...

..Lower hemoglobin is associated with higher morbidity and mortality in hospitalized patients with HF...

..In the future, better control of the allograft immunologic response will likely be the key to attenuating development of this form of atherosclerosis...

..Several medications counter these effects in vitro, and some are in clinical testing...

..CHARM is a randomized, double-blind, placebo-controlled, multicenter, international trial program...

..Early identification of patients at risk for HF and asymptomatic patients with structural heart disease is critical if the human morbidity and mortality toll and the economic burden that HF causes is to be decreased...

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..Hypotension has been proposed as the cause of nesiritide-associated increases in serum creatinine (SCr); however, this hypothesis has not been tested...

..This study was performed to (1) evaluate pre-Tx factors affecting mortality in a single-center experience, and (2) compare these factors with risk factors obtained from multicenter registry reports...

..CONCLUSIONS: These data suggest a role for Ang II receptors in the pathogenesis of TCAD and support a novel concept that TCAD may have its origin in the donor per se and may be modulated by the recipient's inherent biological factors...

..Large randomized clinical trials are warranted to evaluate such a synergistic efficacy...

..Detailed, in vivo data on atherosclerosis in young individuals are limited. Intravascular ultrasonography provides a unique opportunity for in vivo characterization of early atherosclerosis in a clinically relevant context...

..However, de novo lesions continue to develop every year. In patients with evidence of rejection, the rate of progression of transplant vasculopathy correlates with the severity of rejection...

..05). CONCLUSION: Heart transplant recipients of female allografts display increased coronary vasculopathy progression...

..This study analyzes the efficacy of 3-day 100-mg course of prednisone without a tapered regimen for the treatment of asymptomatic moderate cardiac allograft rejection...

..Many questions remain to be answered, but many patients have demonstrated early subjective and objective improvement...

..CONCLUSIONS: Long-term survival following cardiac transplantation is possible although complications are frequent. Beyond 10 years, malignancy is a major cause of death...

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..The study was done to prospectively measure the echocardiographic, hemodynamic and clinical outcomes after partial left ventriculectomy (PLV)...

..We investigated whether patients with mild heart failure due to left ventricular systolic dysfunction were at risk of worsening during digoxin withdrawal...

..Whether BNP levels have long-term prognostic significance is unclear and remains the subject of ongoing prospective study...

..CONCLUSIONS: Cytokines and cytokine receptors are independent predictors of mortality in patients with advanced heart failure. Moreover, circulating levels of cytokines are modified by age, sex, and cause of heart failure...

..A significant correlation between autofluorescence spectroscopy and heart allograft rejection has been described in the rat heterotropic allograft model. However, the use of this technique in human heart transplants has not been validate...

..MRI with tissue tagging is useful for assessing the efficacy of surgical therapies for congestive heart failure...

..Implantable left ventricular assist device (LVAD) insertion complicated by early right ventricular (RV) failure has a poor prognosis and is generally unpredictable...

..001) and episodes of rejection (grade > or = 3; P = 0.03 and grade > or = 2; P = 0.04) compared with the control group...

..We tested a unique new device, the Myosplint device (Myocor, Inc, Maple Grove, Minn), which is designed to change left ventricular shape, reduce left ventricular wall stress, and improve left ventricular systolic function...

..IgG level may be a useful marker for identifying patients at high risk...

..Only AT1R gene transcripts predicted the development of transplant vasculopathy in this preliminary study. These findings potentially support a role of Ang II receptors in the progression of TCAD following cardiac transplantation...

..These observations may have implications for the use of HCV-positive donors in heart transplant recipients...

..Whether this favorable neurohormonal response is predictive of an improved survival requires further evaluation...

..Prospective studies of the assessment and treatment of CAD in patients with AHFS are urgently needed...

..Limited comparative studies assessing the health-related quality of life (HRQL) in heart failure (HF) patients with preserved vs. low ejection fraction (LVEF) have been disparate...

..He was discharged from the hospital 13 days after the operation, and 5 months postoperatively he had returned to New York Heart Association functional class II...

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..Randomized, prospective controlled studies assessing LVAD therapy and cardiomyoplasty are in progress...

..The findings suggest increased intensity of inflammation in rejection occurring at later times posttransplant that are revealed by molecular analyses of the graft...

..We sought to evaluate the characteristics, treatments, and outcomes of patients with preserved and reduced systolic function heart failure (HF)...

..Mean bias between the 2 methods was small, suggesting clinical utility for bioimpedance in patients with complex decompensated heart failure...

..CONCLUSIONS: Severe ventricular ectopy during recovery after exercise is predictive of increased mortality in patients with severe HF and can be used as a prognostic indicator of adverse outcomes in HF cohorts...

..We sought to assess the utility of serial BNP measurements in patients with severe heart failure and attempted to correlate values with invasively derived data...

..Therefore, maintenance of LDL cholesterol as close to pretransplant values as possible may help to limit the rate of progression of acquired allograft vasculopathy...

..Obviously, sudden cardiac death due to sudden heart block or asystole might be attenuated with this strategy...

..The aim of this study was to develop a clinical model predictive of in-hospital mortality in a broad hospitalized heart failure (HF) patient population...

..CONCLUSION: The expression of IP-10, Mig, I-TAC, RANTES, CXCR3, and CCR5 in cardiac allografts significantly correlates with the presence and grade of acute rejection...

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..Serial assessments of anti-donor immunity using different methods will be required to detect and possibly predict outcome in cardiac transplant recipients...

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..To determine the late effectiveness of partial left ventriculectomy and risk factors for failure...

..We sought to compare the clinical outcome and economic cost of dobutamine-based and milrinone-based therapy in patients with acute exacerbation of CHF...

..This will not be an easy task, but the current model of rational drug development followed by a large megatrial is costly and not likely to be sustained indefinitely...

..We explored the incidence and predictors of hyperkalemia in a broad population of heart failure patients...

..This study was undertaken to test the hypothesis that transplant coronary vasculopathy (CV) is associated with increased myocardial protein expression of both tissue factor (TF) and integrin alphavbeta3...

..Statin therapy was significantly associated with lower risk of death and fatal rejection, benefits that were independent of lipid values...

..This study evaluated the association between precipitating factors identified at the time of HF hospital admission and subsequent clinical outcomes...

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..We hypothesized that allosensitized VAD patients have higher levels of immunosuppression and thus different morbidity and causes of mortality...

..The aim of this study was to determine whether angiographically silent early coronary intimal thickening could predict long-term morbidity and mortality...

..To examine this, we obtained posttransplant coronary angiograms from a group of patients bridged with VAD and compared them to post transplant coronary angiograms of a non-VAD cohort...

..We sought to evaluate the effect of a national hospital-based initiative on quality of care in patients hospitalized with HF...

..We evaluated chimerism and stromal cell-derived factor-1 (SDF-1) expression in response to peritransplant ischemic injury following human heart transplantation...

..Cardiac allografts from female donors have been shown to be associated with increased risk of transplant vasculopathy. However, the influence of donor gender on peri-transplantation ischemic injury has not been evaluated...

..However, the impact of Ig replacement in moderately hypogammaglobulinemic patients is unknown...

..This study sought to determine the characteristics and long-term prognosis of anemia in ambulatory patients with chronic heart failure...

..We hypothesized that recurrent acute rejection is associated with increased gene expression of AGTR1 in human heart transplantation...

..Medium-term survival in patients suitable for alternative surgical strategies equals that of cardiac transplantation...

..Special consideration is given to new strategies for treating the adverse effects of abnormal glucose metabolism on the cardiovascular system...

..We sought to assess the influence of peritransplant ischemia and fibrosis on the development of allograft vasculopathy, acute cellular rejection and long-term outcome...

..Elevated plasma volume may be a useful prognosticator; further studies are needed to assess whether manipulation of plasma volume affects prognosis...

..We hypothesized that donor ICH is associated with systemic activation of alpha(V)beta3 in the donor before transplantation...

..Thus, programmed cell death occurs beyond the period of histologic resolution and may play a role in regulation of the rejection process...

..We hypothesized that donor intracerebral hemorrhage (ICH) is associated with activation of the metalloproteinases before transplantation that play a key role in the subsequent development of transplant vasculopathy...

..This study determined the ability of the Soul Mate to detect early rejection of transplanted hearts...

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..CONCLUSION: In ambulatory patients with congestive HF, estimated CrCl predicts all-cause mortality independently of established prognostic variables...

..We sought to define the characteristics of fluid retention after thiazolidinedione (TZD) initiation in patients with established heart failure (HF)...

..Leflunomide, a drug for rheumatoid arthritis, has been reported to have anti-CMV activity. This study reports on its use in 17 transplant recipients with complex CMV syndromes who had failed or were intolerant to other therapies...

..This study investigated outcomes in patients with cardiogenic shock and severe renal dysfunction treated with ventricular assist devices (VAD) as a bridge to cardiac transplantation...

..It is possible that subgroups with lower utilization rates can be targeted for quality improvement initiatives...

..The diagnostic and prognostic values of plasma B-type natriuretic peptide (BNP) testing are established. However, the range of plasma BNP levels present in the setting of chronic, stable systolic heart failure (HF) is unclear...

..397, CI = 1.243-15.553, adjusted p = 0.02). This is the first report to describe splenic up-regulation of AT1R in the presence of spontaneous ICH and its association with subsequent development of transplant vasculopathy...

..Thus coronary angiography is usually required to define the etiology of systolic dysfunction. The extent of scar correlates with QRS duration. This may have implications for the application of cardiac resynchronization therapy...

..This study was designed to examine the safety and efficacy of sodium nitroprusside (SNP) for patients with acute decompensated heart failure (ADHF) and low-output states...

..Acute cellular rejection, a process characterized by T-lymphocyte activation and release of inflammatory cytokines, is associated with increased expression of alphavbeta3...

..However, altered expression of beta-myosin heavy chain in human cardiac rejection has not been determined...

..We explored a possible association between acute cellular rejection and the extent of CAV, and we found a potential confounding variable that may obscure such an association...

..9%, p=0.0012). There was a trend towards an increased rate of allograft vasculopathy in the ICB group (competing risks adjusted hazard ratio 1.39, 95% CI 0.90-2.13, p = 0.14)...

..Both vitronectin receptor (integrin alpha(v)beta3) and tissue factor play key roles in vascular endothelial cell injury. Matrix metalloproteinases (MMPs) are activated in ischemic injury models...

..Allograft coronary vasculopathy results from a complex interplay between immunologic and non-immunologic factors. We devised a computerized biopsy scoring method based on histopathology to predict the development of coronary vasculopathy...

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..We tested the hypothesis that Quilty lesions are associated with increased expression of vitronectin receptor (alphavbeta3) and the subsequent development of coronary vasculopathy...

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..On the other hand, vitamin E in the doses and duration studied (400 IU/day for 4.5 years) did not lower risk significantly...

..Beneficial haemodynamic effects correlated with symptomatic improvement in heart failure patients. Nesiritide appears to be an ideal first-line agent for treatment of patients with acutely decompensated heart failure...

..Intravenous administration of nesiritide, a recombinant human B-type natriuretic peptide, has been shown to produce favorable hemodynamic effects, including balanced vasodilation associated with a rapid improvement in clinical symptoms...

..This article reviews the principles of heart failure disease-management programs and cites evidence that they are beneficial...

..It is important to understand how ventricular assist device implantation in select advanced heart failure patients might precipitate recovery of depressed myocardial function...