Displaying publications 61 - 80 of 167 in total

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  1. Chia PL, Loh SY, Foo D
    Med J Malaysia, 2012 Dec;67(6):582-4.
    PMID: 23770949
    INTRODUCTION: Ventricular tachycardia (VT) storm is an uncommon but life-threatening condition. We describe the incidence, causes and management of VT storm among patients admitted to the coronary care unit of a large tertiary hospital.

    MATERIALS AND METHODS: Between 1 November 2009 and 30 April 2010, 198 patients were admitted to the coronary care unit and 7 (3.5%) presented with VT storm. A retrospective review of their records was conducted. The mean follow-up period was 268 (196 to 345) days.

    RESULTS: The mean age was 67 years and 4 patients were male. One patient had a previous myocardial infarction. All had abnormal left ventricular ejection fraction, median of 30%. Acute myocardial infarction (4 patients) was the most common trigger, followed by decompensated heart failure (1), systemic inflammatory response syndrome on a background of non-ischemic dilated cardiomyopathy (1) and bradycardia-induced polymorphic VT (1). Three patients had polymorphic VT and the rest had monomorphic VT. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful in arrhythmia control. Three patients underwent coronary revascularization, 3 patients received implantable cardioverter-defibrillators, 1 had a permanent cardiac pacemaker, 1 died during the acute episode. Five out of the 6 survivors were prescribed oral beta-blockers upon discharge. On follow-up, none of the patients had a recurrence of the tachyarrhythmia.

    CONCLUSION: Acute myocardial infarction was the main trigger of VT storm in our patients. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful at suppressing VT storm.
    Matched MeSH terms: Heart Failure
  2. Ahmad WA, Khanom M, Yaakob ZH
    Int J Clin Pract, 2011 Aug;65(8):848-51.
    PMID: 21762308 DOI: 10.1111/j.1742-1241.2011.02714.x
    The treatment of heart failure in pregnant women is more difficult than in non-pregnant women, and should always involve a multidisciplinary team approach. Knowledge required includes hemodynamic changes in pregnancy and the resultant effect on women with pre-existing or pregnancy-related cardiovascular disease, cardiovascular drugs in pregnancy, ethical issues and challenges regarding saving mother and baby. In addition, women having high risk cardiac lesions should be counselled strongly against pregnancy and followed up regularly. Pregnancy with heart failure is an important issue, demanding more comprehensive studies.
    Matched MeSH terms: Heart Failure/diagnosis; Heart Failure/physiopathology; Heart Failure/therapy*
  3. Tan G, Abdullah B, Kunanayagam S
    Biomed Imaging Interv J, 2006 Apr;2(2):e13.
    PMID: 21614225 MyJurnal DOI: 10.2349/biij.2.2.e13
    Acquired intra-abdominal arteriovenous fistulas (AVFs) are a rare disorder where the communication most commonly occurs between abdominal aorta and inferior vena cava. Ilio-iliac AVF has been reported previously, but is exceedingly rare. We present a case of spontaneous ilio-iliac AVF in an elderly woman who presented with symptoms of right heart failure where the diagnosis was not considered. The computed tomographic (CT) and angiographic features are described. The current status of management as well as a review of the literature is also presented.
    Matched MeSH terms: Heart Failure
  4. Sudarshan VK, Acharya UR, Ng EY, Tan RS, Chou SM, Ghista DN
    Comput Biol Med, 2016 Apr 1;71:231-40.
    PMID: 26898671 DOI: 10.1016/j.compbiomed.2016.01.028
    Cross-sectional view echocardiography is an efficient non-invasive diagnostic tool for characterizing Myocardial Infarction (MI) and stages of expansion leading to heart failure. An automated computer-aided technique of cross-sectional echocardiography feature assessment can aid clinicians in early and more reliable detection of MI patients before subsequent catastrophic post-MI medical conditions. Therefore, this paper proposes a novel Myocardial Infarction Index (MII) to discriminate infarcted and normal myocardium using features extracted from apical cross-sectional views of echocardiograms. The cross-sectional view of normal and MI echocardiography images are represented as textons using Maximum Responses (MR8) filter banks. Fractal Dimension (FD), Higher-Order Statistics (HOS), Hu's moments, Gabor Transform features, Fuzzy Entropy (FEnt), Energy, Local binary Pattern (LBP), Renyi's Entropy (REnt), Shannon's Entropy (ShEnt), and Kapur's Entropy (KEnt) features are extracted from textons. These features are ranked using t-test and fuzzy Max-Relevancy and Min-Redundancy (mRMR) ranking methods. Then, combinations of highly ranked features are used in the formulation and development of an integrated MII. This calculated novel MII is used to accurately and quickly detect infarcted myocardium by using one numerical value. Also, the highly ranked features are subjected to classification using different classifiers for the characterization of normal and MI LV ultrasound images using a minimum number of features. Our current technique is able to characterize MI with an average accuracy of 94.37%, sensitivity of 91.25% and specificity of 97.50% with 8 apical four chambers view features extracted from only single frame per patient making this a more reliable and accurate classification.
    Matched MeSH terms: Heart Failure
  5. Sudarshan VK, Acharya UR, Ng EY, Tan RS, Chou SM, Ghista DN
    Comput Biol Med, 2016 Apr 1;71:241-51.
    PMID: 26897481 DOI: 10.1016/j.compbiomed.2016.01.029
    Early expansion of infarcted zone after Acute Myocardial Infarction (AMI) has serious short and long-term consequences and contributes to increased mortality. Thus, identification of moderate and severe phases of AMI before leading to other catastrophic post-MI medical condition is most important for aggressive treatment and management. Advanced image processing techniques together with robust classifier using two-dimensional (2D) echocardiograms may aid for automated classification of the extent of infarcted myocardium. Therefore, this paper proposes novel algorithms namely Curvelet Transform (CT) and Local Configuration Pattern (LCP) for an automated detection of normal, moderately infarcted and severely infarcted myocardium using 2D echocardiograms. The methodology extracts the LCP features from CT coefficients of echocardiograms. The obtained features are subjected to Marginal Fisher Analysis (MFA) dimensionality reduction technique followed by fuzzy entropy based ranking method. Different classifiers are used to differentiate ranked features into three classes normal, moderate and severely infarcted based on the extent of damage to myocardium. The developed algorithm has achieved an accuracy of 98.99%, sensitivity of 98.48% and specificity of 100% for Support Vector Machine (SVM) classifier using only six features. Furthermore, we have developed an integrated index called Myocardial Infarction Risk Index (MIRI) to detect the normal, moderately and severely infarcted myocardium using a single number. The proposed system may aid the clinicians in faster identification and quantification of the extent of infarcted myocardium using 2D echocardiogram. This system may also aid in identifying the person at risk of developing heart failure based on the extent of infarcted myocardium.
    Matched MeSH terms: Heart Failure
  6. Sze TL, Abdul Aziz YF, Abu Bakar N, Mohd Sani F, Oemar H
    Iran J Radiol, 2015 Jan;12(1):e6878.
    PMID: 25793089 DOI: 10.5812/iranjradiol.6878
    Coronary artery fistula (CAF) is a rare anomaly of the coronary artery. Patients with this condition are usually asymptomatic. However, cardiac failure may occur later in life due to progressive enlargement of the fistula. Diagnosis is traditionally made by echocardiogram and conventional angiogram. However with the advantage of new technologies such as computed tomography (CT) coronary angiography, the course and communications of these fistulae can be delineated non-invasively and with greater accuracy. We report a case of a left circumflex artery fistula to the coronary sinus which was suspected on echocardiogram and the diagnosis was clinched on ECG-gated CT.
    Matched MeSH terms: Heart Failure
  7. Kok Leng Tan, Seng Loong Ng, Soon Eu Chong1, W Yus Haniff W Isa, Hady, Jun Jie Tan, et al.
    MyJurnal
    Introduction: Iron deficiency (ID) has recently been identified as a threat to patients with heart failure with reduced ejection fraction (HFrEF). This study was conducted to determine the occurrence of ID among HFrEF patients in a Malaysian tertiary hospital and its correlation between left ventricular ejection fraction (LVEF). Methods: Stable patients with LVEF less than 45% were included. Demographic data, LVEF (Simpsons) and cardiac functional status were studied, along with full blood count and iron profile. Results: 81 patients with a mean LVEF of 33.6% were recruited. 43.2% of them were NYHA class II patients, followed by 38.3% class III, 13.6% class I and 4.9% class IV patients. About 2/5 of the study population were anaemic, and of those, 48.5% were iron deficient. Majority of these anaemic patients (87.5%) had an absolute iron deficiency. Pearson’s statistical analysis showed positive correlation between ejection fraction and serum ferritin (r=0.624, p< 0.001), serum iron (r= 0.302, p
    Matched MeSH terms: Heart Failure
  8. Wan Adlina Wan Yusuf, Amelia Alias, Wan Hanifah Wan Hussin1, Mohd Nasir Abdul Kadir, Abdul Rahim Wong
    MyJurnal
    Primary cardiac tumours (PCT) are rare in the paediatric population. They can present in a variety of ways – from being asymptomatic, obstructive with heart failure, strokes, arrhythmias or sudden death. We present a 2-month-old child who was admitted because of heart failure from varying types of arrhythmias and was found on echocardiography to have a large left ventricular tumour. A high clinical suspicion in any infant or child who presents with an unexplained heart murmur, arrhythmias or congestive heart failure should prompt relevant investigations ruling out this entity.
    Matched MeSH terms: Heart Failure
  9. Quek DKL, Alfred E, Ong SBL
    Family Physician, 1991;3:34-38.
    Cough associated with angiotensin converting-enzyme (ACE) inhibitor therapy has been reported in Western communities, where its incidence is disputed. We, therefore, reviewed our patients who were treated with captopril primarily for congestive cardiac failure. 19 of 61 patients (31.1%) receiving an ACE inhibitor had volunteered cough as an important adverse effect, compared with only one of 59 patients who recieved other treatment. In 3 patients, the cough was intolerably severe to require discontinuation of treatment. Another 7 patients were withdrawn from ACE inhibitor treatment because of other adverse effects including deteriorating renal function, insomnia, dizzy spells, ageusia and proteinuria, and skin rash. We suggest that although ACE inhibitors are very beneficial in improving the clinical status of congestive heart failure, intolerable adverse effects are not uncommon and might mandate withdrawal in a sizeable minority (16.4%).
    Matched MeSH terms: Heart Failure
  10. Khoo SSK, Chu CM, Fung YK
    Case Rep Cardiol, 2018;2018:4827907.
    PMID: 29713551 DOI: 10.1155/2018/4827907
    Severe thyrotoxicosis can present with a myriad of cardiovascular complications. It may be mild features such as palpitations, tachycardia, and exertional dyspnea or may progress to life-threatening consequences such as atrial fibrillation, tachyarrhythmias, heart failure, myocardial infarction, and shock. In rare cases, they may present with myocardial ischemia secondary to coronary artery vasospasm. We report a case of a 59-year-old Malay gentleman who presented with fast atrial fibrillation and tachycardia-mediated heart failure that evolved to a silent myocardial infarction secondary to severe coronary artery vasospasm with undiagnosed severe thyrotoxicosis. He had complete resolution of heart failure and no further recurrence of coronary artery vasospasm once treatment for thyrotoxicosis was initiated and euthyroidism achieved. This life-threatening consequence has an excellent prognosis if recognised early and treated promptly.
    Matched MeSH terms: Heart Failure
  11. Keijzers G, Kelly AM, Cullen L, Klim S, Graham CA, Craig S, et al.
    BMJ Open, 2017 02 28;7(2):e013812.
    PMID: 28246137 DOI: 10.1136/bmjopen-2016-013812
    OBJECTIVES: To describe demographic features, assessment, management and outcomes of patients who were diagnosed with heart failure after presenting to an emergency department (ED) with a principal symptom of dyspnoea.

    DESIGN: Planned substudy of the prospective, descriptive cohort study: Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM).

    SETTING: 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia collected data over 3 72-hour periods in May, August and October 2014.

    PARTICIPANTS: Patients with an ED diagnosis of heart failure.

    OUTCOME MEASURES: Outcomes included patient epidemiology, investigations ordered, treatment modalities used and patient outcomes (hospital length of stay (LOS) and mortality).

    RESULTS: 455 (14.9%) of the 3044 patients had an ED diagnosis of heart failure. Median age was 79 years, half were male and 62% arrived via ambulance. 392 (86%) patients were admitted to hospital. ED diagnosis was concordant with hospital discharge diagnosis in 81% of cases. Median hospital LOS was 6 days (IQR 4-9) and in-hospital mortality was 5.1%. Natriuretic peptide levels were ordered in 19%, with lung ultrasound (<1%) and echocardiography (2%) uncommonly performed. Treatment modalities included non-invasive ventilation (12%), diuretics (73%), nitrates (25%), antibiotics (16%), inhaled β-agonists (13%) and corticosteroids (6%).

    CONCLUSIONS: In the Asia Pacific region, heart failure is a common diagnosis among patients presenting to the ED with a principal symptom of dyspnoea. Admission rates were high and ED diagnostic accuracy was good. Despite the seemingly suboptimal adherence to investigation and treatment guidelines, patient outcomes were favourable compared with other registries.

    Matched MeSH terms: Heart Failure/diagnosis*; Heart Failure/epidemiology*; Heart Failure/therapy
  12. Bonsu KO, Owusu IK, Buabeng KO, Reidpath DD, Kadirvelu A
    Int J Cardiol, 2017 Jul 01;238:128-135.
    PMID: 28318656 DOI: 10.1016/j.ijcard.2017.03.014
    BACKGROUND: Mortality associated with heart failure (HF) remains high. There are limited clinical data on mortality among HF patients from African populations. We examined the clinical characteristics, long-term outcomes, and prognostic factors of African HF patients with preserved, mid-range or reduced left ventricular ejection fraction (LVEF).

    METHODS AND RESULTS: We conducted a retrospective longitudinal cohort study of individuals aged ≥18years discharged from first HF admission between January 1, 2009 and December 31, 2013 from the Cardiac Clinic, Directorate of Medicine of the Komfo Anokye Teaching Hospital, Ghana. A total of 1488 patients diagnosed of HF were included in the analysis. Of these, 345 patients (23.2%) had reduced LVEF (LVEF<40%) [HFrEF], 265(17.8%) with mid-range LVEF (40%≥LVEF<50%) [HFmEF] and 878 (59.0%) had preserved LVEF (LVEF≥50%) [HFpEF]. Kaplan-Meier curves and log-rank test demonstrated better prognosis for HFpEF compared to HFrEF and HFmEF patients. An adjusted Cox analysis showed a significantly lower risk of mortality for HFpEF (hazard ratio (HR); 0.74; 95% confidence interval (CI) 0.57-0.94) p=0.015). Multivariate analyses showed that age, higher New York Heart Association (NYHA) functional class, lower LVEF, chronic kidney disease, atrial fibrillation, anemia, diabetes mellitus and absence of statin and aldosterone antagonist treatment were independent predictors of mortality in HF. Although, prognostic factors varied across the three groups, age was a common predictor of mortality in HFpEF and HFmEF.

    CONCLUSIONS: This study identified the clinical characteristics, long-term mortality and prognostic factors of African HF patients with reduced, mid-range and preserved ejection fractions in a clinical setting.
    Matched MeSH terms: Heart Failure/diagnosis*; Heart Failure/epidemiology*; Heart Failure/physiopathology
  13. Cheo SW, Low QJ
    Med J Malaysia, 2019 Oct;74(5):439-440.
    PMID: 31649224
    Systemic lupus erythematosus (SLE) is a common autoimmune disease that we see in our daily clinical practice. It can involve almost every organs in the body. Cardiac manifestations of SLE include pericarditis, myocarditis, heart block, coronary artery disease and others. Here, we report a case of SLE with an uncommon presentation of massive pericardial effusion as initial presentation. Here we also highlight that massive pericardial effusion can also be associated with other complications of SLE such as heart failure and lupus nephritis.
    Matched MeSH terms: Heart Failure
  14. Teh BT, Wan Azman WA, Thuraisingham S, Choy AM, Tan KH, Jesudason P, et al.
    JUMMEC, 1999;4:26-33.
    Activation of the synlpathetic nervous system (SNS) and renin-angiotensin system (RAS) plays a pivotal role in the pathophysiology and progression of the disease in chronic heart failure (CHF). Blocking the activation of the RAS with angiotensin converting enzyme inhibitors not only improves sylnptonls but also prolongs life in symptomatic CHF. Does a similar analogy hold true for the use of ß-blockers in CHF? Evidence from a number of small trials and several recent large prospective trials show that b-blockers may improve ventricular function and symptoms in CHF. In a combination of trials investigating the use of carvedilol (an α, and ß-blocker) in congestive heart failure a mortality benefit appears to be evident. There are still a number of key questions that relnaill unanswered regarding the tolerability, patient type and stage of CHF in which ß-blockers should be advocated. Several large scale trials are in progress to answer some of these questions and also to add further information regarding its efficacy and impact on survival. KEYWORDS: Beta-adrenoreceptor antagonist, congestive heart failure.
    Matched MeSH terms: Heart Failure
  15. Islam MM, Islam MT, Faruque MRI, Samsuzzaman M, Misran N, Arshad H
    Materials (Basel), 2015 Jul 23;8(8):4631-4651.
    PMID: 28793461 DOI: 10.3390/ma8084631
    The design of a compact metamaterial ultra-wideband (UWB) antenna with a goal towards application in microwave imaging systems for detecting unwanted cells in human tissue, such as in cases of breast cancer, heart failure and brain stroke detection is proposed. This proposed UWB antenna is made of four metamaterial unit cells, where each cell is an integration of a modified split ring resonator (SRR), capacitive loaded strip (CLS) and wire, to attain a design layout that simultaneously exhibits both a negative magnetic permeability and a negative electrical permittivity. This design results in an astonishing negative refractive index that enables amplification of the radiated power of this reported antenna, and therefore, high antenna performance. A low-cost FR4 substrate material is used to design and print this reported antenna, and has the following characteristics: thickness of 1.6 mm, relative permeability of one, relative permittivity of 4.60 and loss tangent of 0.02. The overall antenna size is 19.36 mm × 27.72 mm × 1.6 mm where the electrical dimension is 0.20 λ × 0.28 λ × 0.016 λ at the 3.05 GHz lower frequency band. Voltage Standing Wave Ratio (VSWR) measurements have illustrated that this antenna exhibits an impedance bandwidth from 3.05 GHz to more than 15 GHz for VSWR < 2 with an average gain of 4.38 dBi throughout the operating frequency band. The simulations (both HFSS and computer simulation technology (CST)) and the measurements are in high agreement. A high correlation factor and the capability of detecting tumour simulants confirm that this reported UWB antenna can be used as an imaging sensor.
    Matched MeSH terms: Heart Failure
  16. Chia YMF, Teng TK, Tan ESJ, Tay WT, Richards AM, Chin CWL, et al.
    PMID: 29150533 DOI: 10.1161/CIRCOUTCOMES.116.003651
    BACKGROUND: Implantable cardioverter defibrillators (ICDs) are lifesaving devices for patients with heart failure (HF) and reduced ejection fraction. However, utilization and determinants of ICD insertion in Asia are poorly defined. We determined the utilization, associations of ICD uptake, patient-perceived barriers to device therapy and, impact of ICDs on mortality in Asian patients with HF.

    METHODS AND RESULTS: Using the prospective ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry, 5276 patients with symptomatic HF and reduced ejection fraction (HFrEF) from 11 Asian regions and across 3 income regions (high: Hong Kong, Japan, Korea, Singapore, and Taiwan; middle: China, Malaysia, and Thailand; and low: India, Indonesia, and Philippines) were studied. ICD utilization, clinical characteristics, as well as device perception and knowledge, were assessed at baseline among ICD-eligible patients (EF ≤35% and New York Heart Association Class II-III). Patients were followed for the primary outcome of all-cause mortality. Among 3240 ICD-eligible patients (mean age 58.9±12.9 years, 79.1% men), 389 (12%) were ICD recipients. Utilization varied across Asia (from 1.5% in Indonesia to 52.5% in Japan) with a trend toward greater uptake in regions with government reimbursement for ICDs and lower out-of-pocket healthcare expenditure. ICD (versus non-ICD) recipients were more likely to be older (63±11 versus 58±13 year; P<0.001), have tertiary (versus ≤primary) education (34.9% versus 18.1%; P<0.001) and be residing in a high (versus low) income region (64.5% versus 36.5%; P<0.001). Among 2000 ICD nonrecipients surveyed, 55% were either unaware of the benefits of, or needed more information on, device therapy. ICD implantation reduced risks of all-cause mortality (hazard ratio, 0.71; 95% confidence interval, 0.52-0.97) and sudden cardiac deaths (hazard ratio, 0.33; 95% confidence interval, 0.14-0.79) over a median follow-up of 417 days.

    CONCLUSIONS: ICDs reduce mortality risk, yet utilization in Asia is low; with disparity across geographic regions and socioeconomic status. Better patient education and targeted healthcare reforms in extending ICD reimbursement may improve access.

    CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov/ct2/show/NCT01633398. Unique identifier: NCT01633398.

    Matched MeSH terms: Heart Failure/complications; Heart Failure/epidemiology; Heart Failure/therapy*
  17. Luo N, Teng TK, Tay WT, Anand IS, Kraus WE, Liew HB, et al.
    Am Heart J, 2017 Sep;191:75-81.
    PMID: 28888273 DOI: 10.1016/j.ahj.2017.06.016
    BACKGROUND: Assessing health-related quality of life (HRQoL) in patients with heart failure (HF) is an important goal of clinical care and HF research. We sought to investigate ethnic differences in perceived HRQoL and its association with mortality among patients with HF and left ventricular ejection fraction ≤35%, controlling for demographic characteristics and HF severity.

    METHODS AND RESULTS: We compared 5697 chronic HF patients of Indian (26%), white (23%), Chinese (17%), Japanese/Koreans (12%), black (12%), and Malay (10%) ethnicities from the HF-ACTION and ASIAN-HF multinational studies using the Kansas City Cardiomyopathy Questionnaire (KCCQ; range 0-100; higher scores reflect better health status). KCCQ scores were lowest in Malay (58±22) and Chinese (60±23), intermediate in black (64±21) and Indian (65±23), and highest in white (67±20) and Japanese or Korean patients (67±22) after adjusting for age, sex, educational status, HF severity, and risk factors. Self-efficacy, which measures confidence in the ability to manage symptoms, was lower in all Asian ethnicities (especially Japanese/Koreans [60±26], Malay [66±23], and Chinese [64±28]) compared to black (80±21) and white (82±19) patients, even after multivariable adjustment (P

    Matched MeSH terms: Heart Failure/ethnology*; Heart Failure/physiopathology; Heart Failure/psychology
  18. Puttegowda B, Theodore J, Basappa R, Nanjappa MC
    Malays J Med Sci, 2016 Mar;23(2):82-4.
    PMID: 27547120
    A 28-year-old male patient with bipolar disorder taking olanzapine and lorazepam for almost 10 years presented with weight gain, diabetes, and anasarca was examined in this study. Evaluation of the patient revealed he was in heart failure. The reason for his heart failure was ambiguous and an investigation into it revealed negative results. Literature search conducted showed a few reported cases of putative olanzapine induced cardiomyopathy. One such relatively rare case is presented here.
    Matched MeSH terms: Heart Failure
  19. Lim E, Dokos S, Salamonsen RF, Rosenfeldt FL, Ayre PJ, Lovell NH
    Artif Organs, 2012 May;36(5):E125-37.
    PMID: 22489771 DOI: 10.1111/j.1525-1594.2012.01448.x
    Numerical models, able to simulate the response of the human cardiovascular system (CVS) in the presence of an implantable rotary blood pump (IRBP), have been widely used as a predictive tool to investigate the interaction between the CVS and the IRBP under various operating conditions. The present study investigates the effect of alterations in the model parameter values, that is, cardiac contractility, systemic vascular resistance, and total blood volume on the efficiency of rotary pump assistance, using an optimized dynamic heart-pump interaction model previously developed in our laboratory based on animal experimental measurements obtained from five canines. The effect of mean pump speed and the circulatory perturbations on left and right ventricular pressure volume loops, mean aortic pressure, mean cardiac output, pump assistance ratio, and pump flow pulsatility from both the greyhound experiments and model simulations are demonstrated. Furthermore, the applicability of some of the previously proposed control parameters, that is, pulsatility index (PI), gradient of PI with respect to pump speed, pump differential pressure, and aortic pressure are discussed based on our observations from experimental and simulation results. It was found that previously proposed control strategies were not able to perform well under highly varying circulatory conditions. Among these, control algorithms which rely on the left ventricular filling pressure appear to be the most robust as they emulate the Frank-Starling mechanism of the heart.
    Matched MeSH terms: Heart Failure/therapy
  20. Bonsu KO, Reidpath DD, Kadirvelu A
    Cardiovasc Drugs Ther, 2016 Apr;30(2):177-88.
    PMID: 26780905 DOI: 10.1007/s10557-015-6636-z
    OBJECTIVES: This study aims to compare lipophilic and hydrophilic statin therapy on clinical outcomes of heart failure (HF) using a systematic review and an adjusted indirect comparison meta-analysis. Outcomes were all-cause mortality, cardiovascular mortality, cardiovascular hospitalization and hospitalization for worsening HF.

    METHODS: We conducted a search of PubMed, EMBASE and Cochrane databases until 31st December 2014 for randomized control trials (RCTs) in HF evaluating statins versus placebo. Identified RCTs and their respective abstracted information were grouped according to statin type evaluated and analyzed separately. Outcomes were initially pooled with the Peto's one-step method, producing odd ratios (OR) and 95 % confidence intervals (CI) for each statin type. Using these pooled estimates, we performed adjusted indirect comparisons of lipophilic versus hydrophilic statin for each outcome.

    RESULTS: Thirteen studies involving 10,966 patients were identified and analyzed. Lipophilic statins were superior to hydrophilic rosuvastatin regarding all-cause mortality (OR 0 · 50; 95 % CI, 0 · 11-0 · 89; p = 0 · 01), cardiovascular mortality (OR 0 · 61; 0 · 25-0 · 97; p = 0 · 009), and hospitalization for worsening HF (OR 0 · 52; 0 · 21-0 · 83; p = 0 · 0005). However, both statins were comparable with regards to cardiovascular hospitalization [OR 0 · 80 (0 · 31, 1 · 28); p = 0 · 36].

    CONCLUSIONS: Lipophilic statin treatment shows significant decreases in all-cause mortality, cardiovascular mortality and hospitalization for worsening HF compared with rosuvastatin treatment. This meta-analysis provides preliminary evidence that lipophilic statins offer better clinical outcomes in HF till data from head to head comparisons are available.

    Matched MeSH terms: Heart Failure/drug therapy*
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