Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation – results from the CGA-TAVI multicentre registry

Ungar, Andrea; Mannarino, Giulio; Velde, Nathalie van der; Baan, Jan; Thibodeau, Marie-Pierre; Masson, Jean‐Bernard; Santoro, Gennaro; Mourik, Martijn van; Jansen, Sanne; Deutsch, Cornelia; Bramlage, Peter; Kurucova, Jana; Thoenes, Martin; Maggi, Stefania; Schoenenberger, Andreas W.

doi:10.1186/s12872-017-0740-x

Cited by 80 publications

(42 citation statements)

References 46 publications

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“…Excessive preload also leads to elevated venous pressure and the development of peripheral edema and pulmonary congestion [7,8]. These factors contribute to the progressive worsening of HF over time, usually with repeated and costly hospitalizations [9].…”

Section: Introductionmentioning

confidence: 99%

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Basu

Hallow

2020

PLoS Comput Biol

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Congestive heart failure is characterized by suppressed cardiac output and arterial filling pressure, leading to renal retention of salt and water, contributing to further volume overload. Mathematical modeling provides a means to investigate the integrated function and dysfunction of heart and kidney in heart failure. This study updates our previously reported integrated model of cardiac and renal functions to account for the fluid exchange between the blood and interstitium across the capillary membrane, allowing the simulation of edema. A state of heart failure with reduced ejection fraction (HF-rEF) was then produced by altering cardiac parameters reflecting cardiac injury and cardiovascular disease, including heart contractility, myocyte hypertrophy, arterial stiffness, and systemic resistance. After matching baseline characteristics of the SOLVD clinical study, parameters governing rates of cardiac remodeling were calibrated to describe the progression of cardiac hemodynamic variables observed over one year in the placebo arm of the SOLVD clinical study. The model was then validated by reproducing improvements in cardiac function in the enalapril arm of SOLVD. The model was then applied to prospectively predict the response to the sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin, which has been shown to reduce heart failure events in HF-rEF patients in the recent DAPAHF clinical trial by incompletely understood mechanisms. The simulations predict that dapagliflozin slows cardiac remodeling by reducing preload on the heart, and relieves congestion by clearing interstitial fluid without excessively reducing blood volume. This provides a quantitative mechanistic explanation for the observed benefits of SGLT2i in HF-rEF. The model also provides a tool for further investigation of heart failure drug therapies. Recently, the DAPAHF and EMPA-REG clinical trials showed that the Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) class of drugs are beneficial in reducing the heart failure with reduced ejection fraction (HFrEF) hospitalization and lowering the risk of PLOS COMPUTATIONAL BIOLOGY

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Section: Introductionmentioning

confidence: 99%

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Basu

Hallow

2020

PLoS Comput Biol

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“…Among many other noncommunicable disease around the globe, cardiovascular problems accounted for about 17.8 million deaths in 2017, 1 and ischemic heart disease (IHD) is the leading cause of death from cardiovascular and other diseases. 2 IHD remains the single-largest cause of death in countries among all income groups, and ≥80% of deaths occur in developing countries. 3 , 4 IHD represents diseases of related syndromes resulting from myocardial ischemia as a result of disproportionate supply and demand of the heart for perfusion of oxygenated blood.…”

Section: Introductionmentioning

confidence: 99%

<p>Targeting Cardiac Metabolic Pathways: A Role in Ischemic Management</p>

Yehualashet¹,

Belachew²,

Kifle³

et al. 2020

VHRM

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Among the vast number of noncommunicable diseases encountered worldwide, cardiovascular diseases accounted for about 17.8 million deaths in 2017 and ischemic heart disease (IHD) remains the single-largest cause of death in countries across all income groups. Because conventional medications are not without shortcomings and patients still refractory to these medications, scientific investigation is ongoing to advance the management of IHD, and shows a great promise for better treatment modalities, but additional research can warrant improvement in terms of the quality of life of patients. Metabolic modulation is one promising strategy for the treatment of IHD, because alterations in energy metabolism are involved in progression of the disease. Therefore, the purpose of this review was to strengthen attention toward the use of metabolic modulators and to review the current level of knowledge on cardiac energy metabolic pathways.

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“…Ticagrelor is an alternative antiplatelet therapy that is commonly prescribed to patients with acute coronary syndrome (ACS), defined as patients with unstable angina, non-ST-segment elevation myocardial infarctions (NSTEMI), or ST-segment elevation myocardial infarctions (STEMI), as well as patients with a previous history of myocardial infarction (MI) [ 19 , 20 , 21 ]. This medication binds to, and reversibly inhibits the P2Y12 adenosine diphosphate (ADP) receptor on platelets, inhibiting ADP-induced platelet aggregation [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Ticagrelor as an Alternative Antiplatelet Therapy in Cardiac Patients Non-Sensitive to Aspirin

et al. 2020

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Background and Objectives: Aspirin (acetylsalicylic acid—ASA) is a first-line antiplatelet therapy provided to patients with coronary artery disease (CAD). However, it has been demonstrated that 20–30% of these patients are non-sensitive to their ASA therapy. ASA non-sensitivity is a phenomenon where low-dose ASA (81–325 mg) does not completely inhibit arachidonic-acid-induced platelet aggregation, putting patients at risk of adverse cardio-thrombotic events. Ticagrelor is a P2Y12 receptor inhibitor and alternative antiplatelet that has been approved to reduce the risk of stroke, myocardial infarction, and overall cardiovascular-related death. In this study, we aimed to identify ASA non-sensitive patients and evaluate if they would be sensitive to ticagrelor. Materials and Methods: For this pilot study, thirty-eight patients with CAD taking 81 mg ASA were recruited. Blood samples were collected from each patient and platelet rich plasma (PRP) from each sample was isolated. Light-transmission aggregometry (LTA) was used to determine baseline ASA sensitivity in each patient using 0.5 mg/mL arachidonic acid as a platelet agonist. Patients with ≥20% maximal platelet aggregation after activation were considered ASA non-sensitive. Fresh PRP samples from all patients were then spiked with a clinical dosage of ticagrelor (3 μM—approximately equivalent to a loading dose of 180 mg ticagrelor). Sensitivity was determined using LTA and 5 μM ADP as a platelet agonist. Patients with ≥46% maximal platelet aggregation were considered ticagrelor non-sensitive. Results: Of the 38 CAD patients taking 81 mg ASA, 32% (12/38) were non-sensitive to their 81 mg ASA therapy. All 38 of the recruited patients (100%) were sensitive to ticagrelor ex vivo. In conclusion, we were able to identify ASA non-sensitivity using LTA and determine that ASA non-sensitive patients were sensitive to ticagrelor. Conclusions: Our results suggest that ticagrelor is a promising alternative therapy for patients who are non-sensitive to ASA.

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Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation – results from the CGA-TAVI multicentre registry

Cited by 80 publications

References 46 publications

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

Cardiac and renal function interactions in heart failure with reduced ejection fraction: A mathematical modeling analysis

<p>Targeting Cardiac Metabolic Pathways: A Role in Ischemic Management</p>

Ticagrelor as an Alternative Antiplatelet Therapy in Cardiac Patients Non-Sensitive to Aspirin

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