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Patrick Ray - One of the best experts on this subject based on the ideXlab platform.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome
    BMC Cardiovascular Disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Background Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO_2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Conclusion Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome.
    BMC cardiovascular disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Prospective study in an 1,800-bed teaching hospital. Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

Stéphane Jorge - One of the best experts on this subject based on the ideXlab platform.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome
    BMC Cardiovascular Disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Background Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO_2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Conclusion Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome.
    BMC cardiovascular disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Prospective study in an 1,800-bed teaching hospital. Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

Bruce K. Rubin - One of the best experts on this subject based on the ideXlab platform.

  • Cardiac Asthma: new insights into an old disease.
    Expert review of respiratory medicine, 2012
    Co-Authors: Tsuyoshi Tanabe, Henry J. Rozycki, Soichiro Kanoh, Bruce K. Rubin
    Abstract:

    Cardiac Asthma has been defined as wheezing, coughing and orthopnea due to congestive heart failure. The clinical distinction between bronchial Asthma and Cardiac Asthma can be straight forward, except in patients with chronic lung disease coexisting with left heart disease. Pulmonary edema and pulmonary vascular congestion have been thought to be the primary causes of Cardiac Asthma but most patients have a poor response to diuretics. There appears to be limited effectiveness of classical Asthma medications like bronchodilators or corticosteroids in treating Cardiac Asthma. Evidence suggests that circulating inflammatory factors and tissue growth factors also lead to airway obstruction suggesting the possibility of developing novel therapies.

  • Cardiac Asthma: Transforming Growth Factor-β From the Failing Heart Leads to Squamous Metaplasia in Human Airway Cells and in the Murine Lung
    Chest, 2012
    Co-Authors: Tsuyoshi Tanabe, Soichiro Kanoh, William B. Moskowitz, Bruce K. Rubin
    Abstract:

    Background Cardiac Asthma describes symptoms of airflow obstruction due to heart failure. Chronic heart failure is associated with decreased FEV 1 , and FEV 1 improves after heart transplantation. Fibrotic remodeling of the heart and airways is mediated, in part, through transforming growth factor (TGF)-β. Blood TGF-β 1 concentration correlates with ventricular remodeling in Cardiac disease, and TGF-β decreases after repair. Methods We established a coculture of normal human bronchial epithelial (NHBE) cells differentiated at air-liquid interface with submerged basal cardiomyoblasts. Airway cells were immunostained with cytokeratin, actin, and involucrin. TGF-β synthesis was assayed using enzyme-linked immunosorbent assay. Phosphorylation of Smad in NHBE cells was determined by Western blotting. Mice given doxorubicin developed Cardiac failure, and their airways were histologically examined. Results Coculture induced involucrin-positive squamous metaplasia of NHBE cells, and this was attenuated by TGF-β antibody. Total TGF-β 1 was increased in coculture conditioned medium ( P 1 , there was squamous transformation of NHBE cells. One week after removing cardiomyoblasts from culture, squamous metaplasia resolved into normal ciliated epithelia. Smad was phosphorylated in NHBE cells with cardiomyoblasts or with recombinant TGF-β 1 exposure. The airways of mice with heart failure also demonstrated involucrin-positive squamous transformation. Conclusions TGF-β from cardiomyoblasts or from the failing heart can cause airway squamous metaplasia via Smad signaling, and this is blocked by anti-TGF-β antibody and reversed when Cardiac cells are removed from culture. This appears to be an important mechanism for airflow obstruction with heart failure, sometimes described as Cardiac Asthma.

Richard Isnard - One of the best experts on this subject based on the ideXlab platform.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome
    BMC Cardiovascular Disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Background Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO_2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Conclusion Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome.
    BMC cardiovascular disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Prospective study in an 1,800-bed teaching hospital. Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

Mohamed Bennaceur - One of the best experts on this subject based on the ideXlab platform.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome
    BMC Cardiovascular Disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Background Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO_2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Conclusion Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

  • Cardiac Asthma in elderly patients: incidence, clinical presentation and outcome.
    BMC cardiovascular disorders, 2007
    Co-Authors: Stéphane Jorge, Marie-hélène Becquemin, Samuel Delerme, Mohamed Bennaceur, Richard Isnard, Rony Achkar, Bruno Riou, Jacques Boddaert, Patrick Ray
    Abstract:

    Cardiac Asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of Cardiac Asthma with that of classical congestive heart failure (CHF) in elderly patients. Prospective study in an 1,800-bed teaching hospital. Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years) were included. Findings of Cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac Asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137) and the Cardiac Asthma group (n = 75), differed for tobacco use (34% vs. 59%, p < 0.05), history of chronic obstructive pulmonary disease (16% vs. 47%, p < 0.05), peripheral arterial disease (10% vs. 24%, p < 0.05). Patients with Cardiac Asthma had a significantly lower pH (7.38 ± 0.08 vs. 7.43 ± 0.06, p < 0.05), and a higher PaCO2 (47 ± 15 vs. 41 ± 11 mmHg, p < 0.05) at admission. In the Cardiac Asthma group, patients had greater distal airway obstruction: forced expiratory volume in 1 second of 1.09 vs. 1.33 Liter (p < 0.05), and a forced expiratory flow at 25% to 75% of vital capacity of 0.76 vs. 0.99 Liter (p < 0.05). The in-hospital (23% vs. 19%) and one year mortality (48% vs. 43%) rates were similar. Patients with Cardiac Asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.