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INTRODUCTION AND OBJECTIVES: Cirrhosis-related mortality is underestimated and is increasing; extrahepatic factors may contribute. We examined trends in cirrhosis mortality from 1999-2017 in the United States attributed to liver-related (varices, peritonitis, hepatorenal syndrome, hepatic encephalopathy, hepatocellular carcinoma, sepsis) or extrahepatic (cardiovascular disease, influenza and pneumonia, diabetes, malignancy) causes, and compared mortality trends with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) populations. MATERIALS AND METHODS: A national mortality database was used. Changes in age-standardized mortality over time were determined by joinpoint analysis. Average annual percentage change (AAPC) was estimated. RESULTS: Cirrhosis cohort: From 1999-2017, both liver-related (AAPC 1.3%; 95% confidence interval [CI] 0.7-1.9) and extrahepatic mortality (AAPC 1.0%; 95% CI 0.7-1.2) increased. Cirrhosis vs other chronic disease cohorts: changes in all-cause mortality were higher in cirrhosis (AAPC 1.0%; 95% CI 0.7-1.4) than CHF (AAPC 0.1%; 95% CI -0.5- 0.8) or COPD (AAPC -0.4%; 95% CI -0.6- -0.2). Sepsis mortality was highest in cirrhosis (AAPC 3.6%, 95% 3.2- 4.1) compared to CHF (AAPC 0.6%, 95% CI -0.5- 1.7) or COPD (AAPC 0.8%, 95% CI 0.5- 1.2). Cardiovascular mortality increased in cirrhosis (AAPC 1.3%, 95% CI 1.1- 1.5), declined in CHF (AAPC -2.0%, 95% CI -5.3- 1.3) and remained unchanged in COPD (AAPC 0.1%, 95% CI -0.2- 0.4). Extrahepatic mortality was higher among women, rural populations, and individuals >65 years with cirrhosis. CONCLUSIONS: Extrahepatic causes of death are important drivers of mortality and differentially impact cirrhosis compared to other chronic diseases.

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy. Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral [...]

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare  echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare  echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare  echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy. Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral [...](AU)

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare  echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare  echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare  echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/

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In a systematic review and random-effects meta-analysis, we evaluated whether obesity is associated with postoperative atrial fibrillation (POAF) in patients undergoing cardiac operations. We selected 18 observational studies until December 2011 that excluded patients with preoperative AF (n=36,147). Obese patients had a modest higher risk of POAF compared with nonobese (odds ratio, 1.12; 95% confidence interval, 1.04 to 1.21; p=0.002). The association between obesity and POAF did not vary substantially by type of cardiac operation, study design, or year of publication. POAF was significantly associated with a higher risk of stroke, respiratory failure, and operative death.

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