W C Little

..In conclusion, in patients with diastolic dysfunction and hypertensive responses to exercise, 6 months of losartan and HCTZ blunted systolic BP during exercise. Only losartan increased exercise tolerance and improved quality of life...

..The optimal treatment of patients with heart failure and normal ejection fraction has not yet been defined, but the control of systolic hypertension and the avoidance of fluid overload are important...

..Acute studies suggest that treatment with angiotensin II receptor blockers or verapamil may improve exercise tolerance in some patients with primary diastolic dysfunction...

..Patients with diastolic heart failure in the absence of hypertension are very difficult to treat...

..Ang II blockade increased exercise tolerance and improved QOL...

..We conclude that in CHF, circulating ANG II and ET-1 increase to very high levels during Ex and exacerbate the diastolic dysfunction present at rest...

....

..Fast cine MRI can be used to assess left ventricular contraction, but its utility for detection of myocardial ischemia in patients poorly suited for echocardiography is unknown...

..We sought to examine the clinical presentations and subsequent clinical outcomes of patients undergoing target lesion revascularization (TLR) after either bare-metal stent (BMS) or drug-eluting stent (DES) placement...

..The purpose of this study was to determine the level and functional effects of endogenous bradykinin in congestive heart failure (CHF)...

..50 is associated with mild systolic dysfunction and an increased ratio of left ventricular mass to EDVI. In HF with an ejection fraction </=0.40, systolic dysfunction and left ventricular dilation accompany diastolic dysfunction...

..The transmural extent of hyperenhancement correlated inversely with dobutamine SWT (r = -0.7, p <0.001). All segments with dobutamine SWT >/=2 mm showed a transmural extent of hyperenhancement of <50%...

..Thus, with slowed relaxation, E(M) does not respond to the early diastolic LA to LV pressure gradient, because it occurs when LV pressure is greater than or equal to LA pressure...

..The mechanism of the differing remodeling responses is not known, but aging, sex differences, and diabetes may contribute...

..After CHF, LSM produced arterial vasodilatation; improved LV relaxation and diastolic filling; increased contractility, LV arterial coupling, and mechanical efficiency; and normalized the response to Ex...

..CONCLUSION: Sixteen weeks of treatment with the glucose crosslink breaker, alagebrium, resulted in a decrease in left ventricular mass and improvements in left ventricular diastolic filling and quality of life in patient with DHF...

..In conclusion, elevated BNP indicates progressively worse survival in patients with AS treated medically. Thus, the measurement of BNP supplements the evaluation of symptoms in determining the prognoses of patients with AS...

..Heart rate increased only after 0.1 mg/kg LS in normal dogs. In conclusion, oral LS produces vasodilatation and dose-dependent augmentation in LV contractility and relaxation both in normal and HF...

..05 ( P << 0.05). Under normal conditions, LV-arterial coupling remains optimal during increases in HR. After CHF, tachycardia exacerbates the suboptimal baseline LV-arterial coupling, reducing the efficiency of producing SW...

..3% vs 72.4%; odds ratio 3.7; 95% confidence interval 2.2 to 6.3). Thus, an elevated preprocedural WBC count is associated with increased risk of MACEs in patients undergoing PCI for saphenous vein graft lesions...

..In pacing-induced CHF, however, allopurinol improves LV systolic function at rest and during adrenergic stimulation and exercise...

..The goal of this study was to determine if cardiac cycle-dependent changes in proximal thoracic aortic area and distensibility are associated with exercise intolerance in elderly patients with diastolic heart failure (DHF)...

..To evaluate the adjusted risk of vascular complications after thrombin hemostasis patch-facilitated manual compression (THP-MC) for femoral artery access site management...

..Thus, it is important to evaluate both systolic and diastolic function not only to differentiate between diastolic and systolic HF but also to identify high-risk patients...

....

..Whether abciximab can be used safely or effectively during PCI for high-risk patients after upstream treatment with eptifibatide in patients with acute coronary syndromes (ACS) is not known...

..Whether awareness of this gender risk or implementation of strategies to reduce the overall incidence of vascular complications has had an effect on the incidence of vascular complications in women is unknown...

..Exercise training (ET) improves exercise intolerance and QOL in patients with HF with reduced ejection fraction (EF). However, the effect of ET in HFPEF has not been examined in a randomized controlled trial...

....

..The aim was to compare 2-year outcomes with the routine use of drug-eluting stents (DES) (>75% "off-label") with a comparable group treated with bare-metal stents (BMS)...

..Exercise intolerance is the primary symptom in older patients with heart failure and preserved ejection fraction (HFPEF); however, little is known regarding its mechanisms and therapy...

..Use of the ARC probable stent thrombosis paralleled rates of definite stent thrombosis alone, but partially masked the occurrence of late (>1 year) stent thrombosis in DESs compared with BMSs...

..This study sought to evaluate trends in vascular complications after diagnostic cardiac catheterization (CATH) and percutaneous coronary intervention (PCI) from the femoral artery from 1998 to 2007...

....

..Drug-eluting stents (DES) may reduce this effect in select patients; however, whether this benefit occurs in high-risk lesions and patients in routine practice is not clear...

....

..We evaluated the effect of angiotensin II (Ang II) type 1 receptor (AT1) blockade on the development of alcoholic cardiomyopathy...

..Stimulation of beta(3)-AR by endogenous catecholamine contributes to the depression of LV contraction and relaxation in CHF...

..We sought to evaluate late clinical outcomes following elective percutaneous coronary interventions for saphenous vein graft with planned abciximab use in diabetics...

..In this study, we find this heightened risk is present independent of the location of the distal segment within the left ventricular apex...

..The sensitivity and specificity for detecting >70% coronary artery luminal diameter narrowings on contrast coronary angiography were 79% and 85%, respectively...

..There were no major bleeding, vascular repair, vessel occlusion, or embolizations. Three large hematomas (1.7%) were noted. These data suggest that restick can be performed safely after initial Angioseal deployment...

..We discuss issues relevant to management of the restenotic drug-eluting stent in the aorto-ostial location...

..To evaluate the safety and efficacy of newer generations of a single vascular closure device (VCD), Angioseal, compared to contemporaneous manual compression...

..However, the pathophysiology of this disorder, presumptively termed diastolic heart failure (DHF), is not well characterized and it is unknown whether it represents true heart failure...

..To evaluate the adjusted risk of vascular complications after manual compression and vascular closure devices for femoral artery access site management in a large contemporary cohort, using propensity score analysis...

..The study assessed clinical outcomes of closure device use following percutaneous coronary revascularization using current standards of anticoagulation and antiplatelet therapy...

..Further studies are warranted to define the role of rHuEpo in chronic heart failure and other cardiovascular settings...

..We found that anemia is common in these patients and is associated with greater elevations in serum B-type natriuretic peptide, more severe diastolic dysfunction, and a worse prognosis...

..In conclusion, elevated left ventricular filling pressure after maximal exercise predicts increased BNP levels in patients with impaired relaxation pattern...

..Thus, despite the substantial difference in left ventricular size and EF, there is substantial overlap in the CTR between patients with diastolic and systolic HFs and the CTR is unable to discriminate between groups...

..12; P=0.013) and a trend toward improved survival without cardiovascular hospitalization (log-rank 3.02; P=0.082). CONCLUSIONS: Statin therapy may be associated with improved survival in patients with HF and a normal EF...

..We investigated whether the LV restrictive filling pattern is due to elevated LA pressure alone...

..Despite this treatment, however, mortality from heart failure remains high. Current investigation is now focused on other pathophysiological mechanisms and the interruption of these pathways...

..Strict control of hypertension appears to be of paramount importance. Angiotensin-converting enzyme inhibitors or receptor blockers may be of benefit in preventing repeat hospitalizations...

..Moreover, understanding the physiology of diastolic performance remains essential to proper diagnosis and management...

..Early identification of diastolic dysfunction in asymptomatic patients by the use of echocardiography may provide an opportunity to manage the underlying etiology to prevent progression to diastolic heart failure...

....

..We assessed the accuracy of this noninvasive estimate of K(lv) by comparing it with invasive measurement of K(lv) in intact patients with a wide range of LV size and function under varying loading conditions...

..Chagas' disease is an important health problem in Latin America, and cardiac involvement is associated with substantial morbidity and mortality. We developed a model to predict the risk of death in patients with Chagas' heart disease...

..Until the results of such studies are available, it is recommended to use statins in patients with diastolic heart failure who otherwise have an indication for statin therapy...

..Finally, cryptic sites for fibronectin's N-terminal 70-kD fragment were found to be exposed at relatively low strain, demonstrating the assay's potential to analyze stretch-regulated protein-protein interactions...

..32 mmHg/ml. In conclusion, notwithstanding the significant decrement in LA volume, KLA does not change and can be considered not different from zero during DT. Thus KLA does not affect the estimation of KLV from Doppler parameters...