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AI-Guided vs Sonographer Echocardiography Interpretation for Heart Failure Detection: Meta-Analysis Summary Background & Rationale Heart failure affects 64+ million people globally, with heart failure with preserved ejection fraction (HFpEF) comprising ~50% of cases. Current diagnostic approaches suffer from high misdiagnosis rates (up to 75%), significant operator variability, and a projected 139,000 cardiologist shortage by 2033. Over 8 FDA-cleared AI algorithms have emerged for echocardiographic interpretation, with 15+ validation studies showing promising results, yet no systematic comparison exists between AI-guided and standard sonographer interpretation. Research Question Is AI-guided echocardiographic interpretation more accurate than standard sonographer interpretation for detecting heart failure (HFpEF and HFrEF)? Methods Overview Design: Systematic review and meta-analysis of diagnostic accuracy studies Population: Adult patients undergoing echocardiographic assessment Intervention: AI-guided echocardiographic interpretation (any algorithm/platform) Comparator: Standard sonographer interpretation Outcomes: Diagnostic accuracy (sensitivity, specificity, AUC), workflow efficiency Analysis: Bivariate random-effects meta-analysis with hierarchical summary ROC curves Clinical Significance This will be the first comprehensive meta-analysis comparing AI versus human interpretation in echocardiography for heart failure detection. Results will provide critical evidence for: Clinical integration of AI algorithms in cardiac imaging workflows Regulatory decision-making and guideline development Healthcare policy regarding AI adoption in cardiology Economic justification for AI implementation Expected Impact Clinical: Evidence-based recommendations for AI-human workflow optimization Economic: Cost-effectiveness data for healthcare systems facing workforce shortages Regulatory: Support for broader AI algorithm validation and approval Research: Identification of gaps for future AI development priorities Innovation First systematic synthesis of AI vs human diagnostic accuracy in echocardiography Comprehensive analysis of FDA-cleared algorithms across multiple validation studies Direct clinical utility assessment beyond technical performance metrics Real-world implementation guidance for cardiac imaging departments | Target: High-impact cardiology journal | Registration: Open science framework

AI-Guided vs Sonographer Echocardiography Interpretation for Heart Failure Detection: Meta-Analysis Summary Background & Rationale Heart failure affects 64+ million people globally, with heart failure with preserved ejection fraction (HFpEF) comprising ~50% of cases. Current diagnostic approaches suffer from high misdiagnosis rates (up to 75%), significant operator variability, and a projected 139,000 cardiologist shortage by 2033. Over 8 FDA-cleared AI algorithms have emerged for echocardiographic interpretation, with 15+ validation studies showing promising results, yet no systematic comparison exists between AI-guided and standard sonographer interpretation. Research Question Is AI-guided echocardiographic interpretation more accurate than standard sonographer interpretation for detecting heart failure (HFpEF and HFrEF)? Methods Overview Design: Systematic review and meta-analysis of diagnostic accuracy studies Population: Adult patients undergoing echocardiographic assessment Intervention: AI-guided echocardiographic interpretation (any algorithm/platform) Comparator: Standard sonographer interpretation Outcomes: Diagnostic accuracy (sensitivity, specificity, AUC), workflow efficiency Analysis: Bivariate random-effects meta-analysis with hierarchical summary ROC curves Clinical Significance This will be the first comprehensive meta-analysis comparing AI versus human interpretation in echocardiography for heart failure detection. Results will provide critical evidence for: Clinical integration of AI algorithms in cardiac imaging workflows Regulatory decision-making and guideline development Healthcare policy regarding AI adoption in cardiology Economic justification for AI implementation Expected Impact Clinical: Evidence-based recommendations for AI-human workflow optimization Economic: Cost-effectiveness data for healthcare systems facing workforce shortages Regulatory: Support for broader AI algorithm validation and approval Research: Identification of gaps for future AI development priorities Innovation First systematic synthesis of AI vs human diagnostic accuracy in echocardiography Comprehensive analysis of FDA-cleared algorithms across multiple validation studies Direct clinical utility assessment beyond technical performance metrics Real-world implementation guidance for cardiac imaging departments | Target: High-impact cardiology journal | Registration: Open science framework

CHF congestive Heart Failure Nursing Interventions and Nursing Review In this tutorial for nursing students we will cover CHF congestive Heart .Full Article and more nursing care plans: https://nursestudy.net/congestive-heart-failure-chf-nursing-care-plan/5 nursing care plans for CHF: https://nursestudy.net/chf-hf-nursing-care-plans/ Visit NurseStudy.Net we have over 600 Nursing care plans available.Nursing ResourcesRecommended NCLEX Nursing School Review ProgramNCLEX Review ProgramRecommended BooksNursing Diagnosis HandbookNursing Care Plans HandbookMedical Surgical NursingComprehensive NCLEX Review*Social*Web: https://nursestudy.net/Shop: https://amzn.to/36jrZCNInstagramPinterestThe description contains affiliate links and I may be compensated a small amount if you make a purchase after clicking on my links.DisclaimerThis lesson is not intended to provide medical advice. The articles on this website are intended for entertainment or educational value only. While we strive to offer 100% accuracy, we cannot guarantee the validity or accuracy of any content. Medical procedures are rapidly changing, and laws vary greatly from location. #NCLEX #Nursing #NursingStudent

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This article is from Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease , volume 3 . Abstract Background: Systemic hypertension is a common characteristic in acute heart failure (HF). This increasingly recognized phenotype is commonly associated with renal dysfunction and there is an unmet need for renal enhancing therapies. In a canine model of HF and acute vasoconstrictive hypertension we characterized and compared the cardiorenal actions of M‐atrial natriuretic peptide (M‐ANP), a novel particulate guanylyl cyclase (pGC) activator, and nitroglycerin, a soluble guanylyl cyclase (sGC) activator. Methods and Results: HF was induced by rapid RV pacing (180 beats per minute) for 10 days. On day 11, hypertension was induced by continuous angiotensin II infusion. We characterized the cardiorenal and humoral actions prior to, during, and following intravenous M‐ANP (n=7), nitroglycerin (n=7), and vehicle (n=7) infusion. Mean arterial pressure (MAP) was reduced by M‐ANP (139±4 to 118±3 mm Hg, P

This article is from Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease , volume 3 . Abstract Background: Systemic hypertension is a common characteristic in acute heart failure (HF). This increasingly recognized phenotype is commonly associated with renal dysfunction and there is an unmet need for renal enhancing therapies. In a canine model of HF and acute vasoconstrictive hypertension we characterized and compared the cardiorenal actions of M‐atrial natriuretic peptide (M‐ANP), a novel particulate guanylyl cyclase (pGC) activator, and nitroglycerin, a soluble guanylyl cyclase (sGC) activator. Methods and Results: HF was induced by rapid RV pacing (180 beats per minute) for 10 days. On day 11, hypertension was induced by continuous angiotensin II infusion. We characterized the cardiorenal and humoral actions prior to, during, and following intravenous M‐ANP (n=7), nitroglycerin (n=7), and vehicle (n=7) infusion. Mean arterial pressure (MAP) was reduced by M‐ANP (139±4 to 118±3 mm Hg, P

This article is from Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease , volume 3 . Abstract Background: Systemic hypertension is a common characteristic in acute heart failure (HF). This increasingly recognized phenotype is commonly associated with renal dysfunction and there is an unmet need for renal enhancing therapies. In a canine model of HF and acute vasoconstrictive hypertension we characterized and compared the cardiorenal actions of M‐atrial natriuretic peptide (M‐ANP), a novel particulate guanylyl cyclase (pGC) activator, and nitroglycerin, a soluble guanylyl cyclase (sGC) activator. Methods and Results: HF was induced by rapid RV pacing (180 beats per minute) for 10 days. On day 11, hypertension was induced by continuous angiotensin II infusion. We characterized the cardiorenal and humoral actions prior to, during, and following intravenous M‐ANP (n=7), nitroglycerin (n=7), and vehicle (n=7) infusion. Mean arterial pressure (MAP) was reduced by M‐ANP (139±4 to 118±3 mm Hg, P

This article is from Journal of Korean Medical Science , volume 28 . Abstract This study investigated the role of angiotensin II receptor blocker in atrial remodeling in rats with atrial fibrillation (AF) induced by a myocardial infarction (MI). MIs were induced by a ligation of the left anterior descending coronary artery. Two days after, the rats in the losartan group were given losartan (10 mg/kg/day for 10 weeks). Ten weeks later, echocardiography and AF induction studies were conducted. Ejection fraction was significantly lower in the MI rats. Fibrosis analysis revealed much increased left atrial fibrosis in the MI group than sham (2.22 ± 0.66% vs 0.25 ± 0.08%, P = 0.001) and suppression in the losartan group (0.90 ± 0.27%, P 0.001) compared with the MI group. AF inducibility was higher in the MI group than sham (39.4 ± 43.0% vs 2.0 ± 6.3%, P = 0.005) and significantly lower in losartan group (12.0 ± 31.6%, P = 0.029) compared with the MI. The left atrial endothelial nitric oxide synthase (NOS) and sarco/endoplasmic reticulum Ca2+-ATPase levels were lower in the MI group and higher in the losartan group significantly. The atrial inducible NOS and sodium-calcium exchanger levels were higher in the MI and lower in the losartan group significantly. Losartan disrupts collagen fiber formation and prevents the alteration of the tissue eNOS and iNOS levels, which prevent subsequent AF induction.

This article is from Current Cardiology Reviews , volume 9 . Abstract Heart failure is a major health problem that affects patients and healthcare systems worldwide. Within the continent of North America, differences in economic development, genetic susceptibility, cultural practices, and trends in risk factors and treatment all contribute to both inter-continental and within-continent differences in heart failure. The United States and Canada represent industrialized countries with similar culture, geography, and advanced economies and infrastructure. During the epidemiologic transition from rural to industrial in countries such as the United States and Canada, nutritional deficiencies and infectious diseases made way for degenerative diseases such as cardiovascular diseases, cancer, overweight/obesity, and diabetes. This in turn has resulted in an increase in heart failure incidence in these countries, especially as overall life expectancy increases. Mexico, on the other hand, has a less developed economy and infrastructure, and has a wide distribution in the level of urbanization as it becomes more industrialized. Mexico is under a period of epidemiologic transition and the etiology and incidence of heart failure is rapidly changing. Ethnic differences within the populations of the United States and Canada highlight the changing demographics of each country as well as potential disparities in heart failure care. Heart failure with preserved ejection fraction makes up approximately half of all hospital admissions throughout North America; however, important differences in demographics and etiology exist between countries. Similarly, acute heart failure etiology, severity, and management differ between countries in North America. The overall economic burden of heart failure continues to be large and growing worldwide, with each country managing this burden differently. Understanding the inter-and within-continental differences may help improve understanding of the heart failure epidemic, and may aid healthcare systems in delivering better heart failure prevention and treatment.

This article is from Current Cardiology Reviews , volume 9 . Abstract Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries.

This article is from PLoS ONE , volume 9 . Abstract Background: Transgenic mice with transient cardiac expression of constitutively active Galpha q (Gαq-TG) exhibt progressive heart failure and ventricular arrhythmias after the initiating stimulus of transfected constitutively active Gαq becomes undetectable. However, the mechanisms are still unknown. We examined the effects of chronic administration of olmesartan on heart failure and ventricular arrhythmia in Gαq-TG mice. Methodology/Principal Findings: Olmesartan (1 mg/kg/day) or vehicle was chronically administered to Gαq-TG from 6 to 32 weeks of age, and all experiments were performed in mice at the age of 32 weeks. Chronic olmesartan administration prevented the severe reduction of left ventricular fractional shortening, and inhibited ventricular interstitial fibrosis and ventricular myocyte hypertrophy in Gαq-TG. Electrocardiogram demonstrated that premature ventricular contraction (PVC) was frequently (more than 20 beats/min) observed in 9 of 10 vehicle-treated Gαq-TG but in none of 10 olmesartan-treated Gαq-TG. The collected QT interval and monophasic action potential duration in the left ventricle were significantly shorter in olmesartan-treated Gαq-TG than in vehicle-treated Gαq-TG. CTGF, collagen type 1, ANP, BNP, and β-MHC gene expression was increased and olmesartan significantly decreased the expression of these genes in Gαq-TG mouse ventricles. The expression of canonical transient receptor potential (TRPC) 3 and 6 channel and angiotensin converting enzyme (ACE) proteins but not angiotensin II type 1 (AT1) receptor was increased in Gαq-TG ventricles compared with NTG mouse ventricles. Olmesartan significantly decreased TRPC6 and tended to decrease ACE expressions in Gαq-TG. Moreover, it increased AT1 receptor in Gαq-TG. Conclusions/Significance: These findings suggest that angiotensin II type 1 receptor activation plays an important role in the development of heart failure and ventricular arrhythmia in Gαq-TG mouse model of heart failure.

This article is from Lupus , volume 22 . Abstract We describe a female patient with systemic lupus erythematosus (SLE) also diagnosed with Fabry’s disease and anti-phospholipid antibody syndrome (APS). SLE and Fabry’s disease are both systemic diseases with variable clinical presentations. Recent studies have shown a relatively high incidence of late onset Fabry’s disease in female heterozygous individuals, suggesting that this condition could be under-diagnosed. We discuss a possible association between SLE and Fabry’s disease and consider the role of lipid abnormalities in the pathogenesis of SLE.

This article is from Journal of Multidisciplinary Healthcare , volume 7 . Abstract Background: Functional decline of hospitalized older adults is common and triggers health care expenditures. Physical therapy can retard the functional decline that occurs during hospitalization. This study aims to examine whether shared situational awareness (SSA) intervention may enhance the benefits of physical therapy for hospitalized older persons with a common diagnosis, heart failure. Method: An SSA intervention that involved daily multidisciplinary meetings was applied to the care of functionally declining older adults admitted to the medicine floor for heart failure. Covariates were matched between the intervention group (n=473) and control group (n=475). Both intervention and control groups received physical therapy for ≥0.5 hours per day. The following three outcomes were compared between groups: 1) disability, 2) transition to skilled nursing facility (SNF, post-acute care setting), and 3) 30-day readmission rate. Results: Disability was lower in the intervention group (28%) than in the control group (37%) (relative risk [RR] =0.74; 95% confidence interval [CI], 0.35–0.97; P=0.026), and transition to SNF was lower in the intervention group (22%) than in the control group (30%) (RR =0.77; 95% CI, 0.39–0.98; P=0.032). The 30-day readmission rate did not significantly differ between the two groups. Conclusion: SSA intervention enhanced the benefits of physical therapy for functionally declining older adults. When applied to older adults with heart failure in the form of daily multidisciplinary meetings, SSA intervention improved functional outcomes and reduced transfer to SNFs after hospitalization.

This article is from PLoS ONE , volume 9 . Abstract Background: Effects of beta-blockers on the prognosis of the heart failure patients with preserved ejection fraction (HFpEF) remain controversial. The aim of this meta-analysis was to determine the impact of beta-blockers on mortality and hospitalization in the patients with HFpEF. Methods: A search of MEDLINE, EMBASE, and the Cochrane Library databases from 2005 to June 2013 was conducted. Clinical studies reporting outcomes of mortality and/or hospitalization for patients with HFpEF (EF ≥ 40%), being assigned to beta-blockers treatment and non-beta-blockers control group were included. Results: A total of 12 clinical studies (2 randomized controlled trials and 10 observational studies) involving 21,206 HFpEF patients were included for this meta-analysis. The pooled analysis demonstrated that beta-blocker exposure was associated with a 9% reduction in relative risk for all-cause mortality in patients with HFpEF (95% CI: 0.87 – 0.95; P < 0.001). Whereas, the all-cause hospitalization, HF hospitalization and composite outcomes (mortality and hospitalization) were not affected by this treatment (P = 0.26, P = 0.97, and P = 0.88 respectively). Conclusions: The beta-blockers treatment for the patients with HFpEF was associated with a lower risk of all-cause mortality, but not with a lower risk of hospitalization. These finding were mainly obtained from observational studies, and further investigations are needed to make an assertion.

The study of pathological cardiac conditions such as arrhythmias, a major cause of mortality in heart failure, is becoming increasingly informed by computational simulation, numerically modelling the governing equations. This can provide insight where experimental work is constrained by technical limitations and/or ethical issues. As the models become more realistic, the construction of efficient and accurate computational models becomes increasingly challenging. In particular, recent developments have started to couple the electrophysiology models with mechanical models in order to investigate the effect of tissue deformation on arrhythmogenesis, thus introducing an element of nonlinearity into the mathematical representation. This paper outlines a biophysically-detailed computational model of coupled electromechanical cardiac activity which uses the finite element method to approximate both electrical and mechanical systems on unstructured, deforming, meshes. An ILU preconditioner is applied to improve performance of the solver. This software is used to examine the role of electrophysiology, fibrosis and mechanical deformation on the stability of spiral wave dynamics in human ventricular tissue by applying it to models of both healthy and failing tissue. The latter was simulated by modifying (i) cellular electrophysiological properties, to generate an increased action potential duration and altered intracellular calcium handling, and (ii) tissue-level properties, to simulate the gap junction remodelling, fibrosis and increased tissue stiffness seen in heart failure. The resulting numerical experiments suggest that, for the chosen mathematical models of electrophysiology and mechanical response, introducing tissue level fibrosis can have a destabilising effect on the dynamics, while the net effect of the electrophysiological remodelling stabilises the system.

This article is from Drug Design, Development and Therapy , volume 7 . Abstract Although there have been significant advances in the therapy of heart failure in recent decades, such as the introduction of β-blockers and antagonists of the renin–angiotensin–aldosterone system, this devastating disease still carries tremendous morbidity and mortality in the western world. G protein-coupled receptors, such as β-adrenergic and angiotensin II receptors, located in the membranes of all three major cardiac cell types, ie, myocytes, fibroblasts, and endothelial cells, play crucial roles in regulation of cardiac function in health and disease. Their importance is reflected by the fact that, collectively, they represent the direct targets of over one-third of the currently approved cardiovascular drugs used in clinical practice. Over the past few decades, advances in elucidation of the signaling pathways they elicit, specifically in the heart, have led to identification of an increasing number of new molecular targets for heart failure therapy. Here, we review these possible targets for heart failure therapy that have emerged from studies of cardiac G protein-coupled receptor signaling in health and disease, with a particular focus on the main cardiac G protein-coupled receptor types, ie, the β-adrenergic and the angiotensin II type 1 receptors. We also highlight key issues that need to be addressed to improve the chances of success of novel therapies directed against these targets.

This article is from Clinics , volume 66 . Abstract BACKGROUND:: A limited number of studies have used Tissue Doppler Imaging (TDI) to evaluate the effect of statin therapy on left ventricular dysfunction in patients with chronic heart failure. In this work, we aimed to determine whether statin administration influenced prognosis, inflammatory activation and myocardial performance evaluated by Tissue Doppler Imaging in subjects enrolled in the Daunia Heart Failure Registry, a local registry of patients with chronic heart failure. METHODS:: This study retrospectively analyzed 353 consecutive outpatients with chronic heart failure (mean follow-up 384 days), based on whether statin therapy was used. In all patients, several Tissue Doppler Imaging parameters were measured; circulating levels of interleukin (IL)-6, IL-10 and C-reactive protein were also assayed. RESULTS:: Statin administration in 128 subjects with ischemic heart disease was associated with a lower incidence of adverse events (rehospitalization for HF 15% vs. 46%, p

This article is from Diabetes Care , volume 33 . Abstract OBJECTIVE: Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS: We evaluated the association of diabetes and A1C with incident heart failure in outpatients with stable CAD and no history of heart failure (average follow-up 4.1 years). RESULTS: Of 839 participants, 200 had diabetes (23.8%). Compared with patients who did not have diabetes, those with diabetes had an increased risk of heart failure (hazard ratio [HR] 2.17 [95% CI 1.37–3.44]). Adjustment for risk factors for CAD (age, sex, race, smoking, physical inactivity, obesity, blood pressure, and LDL cholesterol), interim myocardial infarction, and myocardial ischemia did not alter the strength of the association between diabetes and heart failure. After inclusion also of other risk factors for heart failure (left ventricular ejection fraction, diastolic dysfunction, and C-reactive protein) and medication use, diabetes remained an independent predictor of heart failure (HR 3.34 [95% CI 1.65–6.76]; P = 0.001). Each 1% increase in A1C concentration was associated with a 36% increased HR of heart failure hospitalization (HR 1.36 [95% CI 1.17–1.58]). CONCLUSIONS: In patients with stable CAD who are free from heart failure at baseline, diabetes and glycemic control are independent risk factors for new-onset heart failure. The mechanisms by which diabetes and hyperglycemia lead to heart failure deserve further study, as the association is independent of baseline functional assessment of ischemia, systolic and diastolic function, and interim myocardial infarction.

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Book Source: Digital Library of India Item 2015.547993 dc.contributor.author: Holland, William C. dc.date.accessioned: 2015-10-14T19:10:00Z dc.date.available: 2015-10-14T19:10:00Z dc.date.copyright: 1960 dc.date.digitalpublicationdate: 2011/01 dc.date.citation: 1960 dc.identifier.barcode: 04990010027520 dc.identifier.origpath: /data8/upload/0224/802 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/547993 dc.description.scannerno: Banasthali University dc.description.scanningcentre: C-DAK, Kolkata dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 130 dc.format.mimetype: application/pdf dc.language.iso: Sanskrit dc.publisher.digitalrepublisher: Digital Library of India dc.publisher: U. S. A., Charles C Thomas dc.rights: Copyright permitted dc.source.library: Dr. Robert Heiling Library, S.m.s.medical College, Jaipur dc.subject.classification: Medical dc.title: Chemistry Of Heart Failure dc.type: Print - Paper dc.type: Book

Book Source: Digital Library of India Item 2015.547861 dc.contributor.author: Master, Arthur M. dc.date.accessioned: 2015-10-14T18:52:28Z dc.date.available: 2015-10-14T18:52:28Z dc.date.copyright: 1955 dc.date.digitalpublicationdate: 2011/01 dc.date.citation: 1955 dc.identifier.barcode: 04990010027376 dc.identifier.origpath: /data8/upload/0224/658 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/547861 dc.description.scannerno: Banasthali University dc.description.scanningcentre: C-DAK, Kolkata dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 209 dc.format.mimetype: application/pdf dc.language.iso: Sanskrit dc.publisher.digitalrepublisher: Digital Library of India dc.publisher: Philadelphia, Lea & Febiger dc.rights: Copyright permitted dc.source.library: Dr. Robert Heiling Library, S.m.s.medical College, Jaipur dc.subject.classification: Medical dc.title: Gardiag Emergencies And Heart Failure(second Edition) dc.type: Print - Paper dc.type: Book

Book Source: Digital Library of India Item 2015.547861 dc.contributor.author: Master, Arthur M. dc.date.accessioned: 2015-10-14T18:52:28Z dc.date.available: 2015-10-14T18:52:28Z dc.date.copyright: 1955 dc.date.digitalpublicationdate: 2011/01 dc.date.citation: 1955 dc.identifier.barcode: 04990010027376 dc.identifier.origpath: /data8/upload/0224/658 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/547861 dc.description.scannerno: Banasthali University dc.description.scanningcentre: C-DAK, Kolkata dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 209 dc.format.mimetype: application/pdf dc.language.iso: Sanskrit dc.publisher.digitalrepublisher: Digital Library of India dc.publisher: Philadelphia, Lea & Febiger dc.rights: Copyright permitted dc.source.library: Dr. Robert Heiling Library, S.m.s.medical College, Jaipur dc.subject.classification: Medical dc.title: Gardiag Emergencies And Heart Failure(second Edition) dc.type: Print - Paper dc.type: Book

Non-communicable diseases are rapidly becoming the commonest cause of mortality in sub-Saharan Africa. Africa has one of the largest prevalence of diabetes mellitus in the world. However, the medical, economic, social and emotional barriers against optimal care of patients with diabetes are very prominent in sub-Saharan Africa. Therefore, poor glycemic control and suboptimal control of other risk factors are not uncommon. These increase the risk of developing cardiovascular complications of diabetes, the endpoint of which is often heart failure. The care for heart failure patients in sub-saharan Africa has been documented to be significantly low when compared with Asia or Southern America. The direct and indirect costs are unbearable and access to care is often compromised. So, when a patient with diabetes develops heart failure in sub-Saharan Africa, the burden is further magnified out of proportion to other developing regions in the world. This review article aims to highlight the peculiarities of the burden of care for heart failure patients with diabetes so that concerted efforts can be directed at addressing the challenges. This will lead to improved care of patients with diabetes and prevent them from developing cardiovascular complications like heart failure or to optimally manage these complications if they arise. 

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A first-of-its-kind heart failure drug wins approval from the Food and Drug Administration.

This scope review project aims to analyze the current evidence regarding the role of microRNAs (miRNAs) as potential biomarkers for the early diagnosis of heart failure (HF). HF is a serious cardiovascular disease with high prevalence and mortality, and early diagnosis is crucial for improving prognosis. The methodology will follow the PRISMA-ScR framework, searching databases such as MEDLINE (PubMed), Embase, and SCOPUS, with study selection by two independent reviewers. Data will be analyzed descriptively to identify specific miRNAs related to HF, seeking to establish their sensitivity and specificity as markers. Expected results include elucidating the link between miRNAs and HF, advancing knowledge of biomolecular mechanisms, and identifying biological markers that could revolutionize current diagnostic methods. The research also aims to highlight knowledge gaps to stimulate future studies, benefiting patients with heart failure and cardiovascular diseases.

Aspiring Women - Listen to Your Heart - Beating Heart Failure -2-27-20-

Cardiovascular Pharmacology Cardiology PJ Shukle

Heart failure (HF) is the end-stage manifestation of all heart diseases, with left heart failure (LHF) being the most prevalent form. We aimed to develop and validate machine learning-based models for predicting in-hospital mortality in intensive care unit (ICU) patients with LHF and implement them as a software tool.

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This article is from The Journal of Tehran University Heart Center , volume 8 . Abstract Background:: Several echocardiographic markers have been introduced to assess the left ventricular (LV) mechanical dyssynchrony. We studied dyssynchrony markers and the latest LV activation site in heart failure patients with and without left bundle branch block (LBBB). Methods:: Conventional echocardiography and tissue velocity imaging were performed for 78 patients (LV ejection fraction ≤ 35%), who were divided into two groups: LBBB (n = 37) and non-LBBB (n = 41). Time-to-peak systolic velocity (Ts) was measured in 12 LV segments in the mid and basal levels. Seven dyssynchrony markers were defined: delay and standard deviation (SD) of Ts in all and basal segments, septal-lateral and anteroseptal-posterior wall delay (at the basal level), and interventricular mechanical delay (IVMD). Results:: The LBBB patients had significantly higher QRS duration and IVMD. The posterior wall was the latest activated site in the LBBB and the inferior wall was the latest in the non-LBBB patients. The most common dyssynchrony marker in the LBBB group was the SD of Ts in all segments (73%), whereas it was Ts delay in the basal segments in the non-LBBB group (48.8%). Ts delay and SD of all LV segments, septal lateral delay, septal-to-posterior wall delay by M-mode, pre-ejection period of the aortic valve, and IVMD were significantly higher in the LBBB group than in the non-LBBB group. Also, 29.3% of the non-LBBB and 10.8% of the LBBB patients did not show dyssynchrony by any marker. The number of patients showing dyssynchrony by ≥ 3 markers was remarkably higher in the LBBB patients (73% vs. 43.9%, respectively; p value = 0.044). Conclusion:: The LBBB patients presented with a higher prevalence of dyssynchrony according to the frequently used echocardiographic markers. The latest activation site was different between the groups.

This systematic review will evaluate the comparative effectiveness and safety of pharmacological interventions (SGLT2 inhibitors, MRAs, diuretics, ACEi/ARBs, ARNIs) for managing patients with concurrent heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%) and kidney dysfunction (eGFR &lt;60 mL/min/1.73m² or albuminuria). The primary outcomes will include cardiovascular mortality, heart failure hospitalization, and kidney function decline. Secondary outcomes will include quality of life, hyperkalemia, and acute kidney injury. We will search major databases including MEDLINE, Embase, and Cochrane CENTRAL for randomized controlled trials and high-quality observational studies from inception to present. If sufficient data are available, network meta-analysis will be conducted to compare treatment strategies. The results will provide evidence-based guidance for optimizing management of this challenging clinical syndrome.

This article is from Korean Circulation Journal , volume 42 . Abstract Background and Objectives: Cardiac resynchronization therapy (CRT) has been known to improve the outcome of advanced heart failure (HF) but is still underutilized in clinical practice. We investigated the prognosis of patients with advanced HF who were suitable for CRT but were treated with conventional strategies. We also developed a risk model to predict mortality to improve the facilitation of CRT. Subjects and Methods: Patients with symptomatic HF with left ventricular ejection fraction ≤35% and QRS interval >120 ms were consecutively enrolled at cardiovascular hospital. After excluding those patients who had received device therapy, 239 patients (160 males, mean 67±11 years) were eventually recruited. Results: During a follow-up of 308±236 days, 56 (23%) patients died. Prior stroke, heart rate >90 bpm, serum Na ≤135 mEq/L, and serum creatinine ≥1.5 mg/dL were identified as independent factors using Cox proportional hazards regression. Based on the risk model, points were assigned to each of the risk factors proportional to the regression coefficient, and patients were stratified into three risk groups: low- (0), intermediate-(1-5), and high-risk (>5 points). The 2-year mortality rates of each risk group were 5, 31, and 64 percent, respectively. The C statistic of the risk model was 0.78, and the model was validated in a cohort from a different institution where the C statistic was 0.80. Conclusion: The mortality of patients with advanced HF who were managed conventionally was effectively stratified using a risk model. It may be useful for clinicians to be more proactive about adopting CRT to improve patient prognosis.

This article is from Experimental and Therapeutic Medicine , volume 4 . Abstract The findings on the association between fish intake and the risk of heart failure (HF) have been inconsistent. The purpose of this study was to clarify this potential association. We searched for relevant studies in the PubMed database through January 2012 and manually reviewed references. Five independent prospective cohort studies involving 5,273 cases and 144,917 participants were included. The summary relative risk estimates (SRRE) based on the highest compared with the lowest category of fish consumption were estimated by variance-based meta-analysis. In addition, we performed sensitivity and dose-response analyses to examine the association. Overall, an absence of an association between fish intake and HF was observed (SRRE=1.00; 95% CI, 0.81–1.24). However, fried fish intake positively associated with HF (SRRE=1.40; 95% CI, 1.22–1.61). In addition, dose-response analysis of fried fish suggested that each increment of six fried fish per month corresponded to a 37% increase of HF rate (RR=1.37; 95% CI, 1.20–1.56). In conclusion, our findings suggest that there is no significant association between fish intake and risk of HF, with the exception of a possible positive correlation with individuals comsuming fried fish, based on a limited number of studies. Future studies are required to confirm these findings.

This article is from Cardiovascular Journal of Africa , volume 23 . Abstract Background: Various conventional methods are used for functional evaluation and risk stratification in heart failure. A combined index of global myocardial performance called the Tei index has been described. The aim of this study was to evaluate the correlation of the Tei index with other conventional indices of systolic and diastolic function among Nigerians with hypertensive heart failure. Methods: Fifty-five subjects with hypertensive heart failure and 30 controls were examined, a clinical history was taken, and echocardiography was performed on them. The subjects were categorised into four groups based on their ejection fraction (normal ejection fraction, mild, moderate and severe heart failure). The Tei index was calculated as the sum of the isovolumic relaxation and contraction time, divided by the ejection time. Statistical analysis was done using SPSS 16.0. Results: The Tei index was significantly higher among subjects with hypertensive heart failure compared with the controls (0.91 ± 0.33 vs 0.28 ± 0.16, p < 0.005). The Tei index also increased with the severity of the heart failure and was inversely correlated with ejection fraction (r = –0.697, p < 0.001) and fractional shortening (r = –0.580, p = 0.001). It was directly correlated with mitral E/A ratio (r = 0.246, p = 0.030), left ventricular internal diastolic dimension (r = 0.414, p = 0.002), left ventricular internal systolic dimension (r = 0.596, p < 0.001) and deceleration time (r = 0.219, p = 0.032). Conclusion: The Tei index correlated significantly with other conventional indices of systolic and diastolic function among Nigerians with hypertensive heart failure. It can be used as a risk-stratification index similar to other traditional indices of systolic and diastolic function.

This article is from PLoS ONE , volume 9 . Abstract Background and Aim: Intermedin (IMD) is a member of calcitonin/calcitonin gene-related peptide (CGRP) family together with adrenomedullin (AM) and amylin. It has a wide distribution in the central nervous system (CNS) especially in hypothalamic paraventricular nucleus (PVN). Cardiac sympathetic afferent reflex (CSAR) is enhanced in chronic heart failure (CHF) rats. The aim of this study is to determine the effect of IMD in the PVN on CSAR and its related mechanisms in CHF rats. Methodology/Principal Findings: Rats were subjected to left descending coronary artery ligation to induce CHF or sham-operation (Sham). Renal sympathetic nerve activity (RSNA), mean arterial pressure (MAP) and heart rate (HR) were recorded. CSAR was evaluated by the RSNA and MAP responses to epicardial application of capsaicin. Acute experiments were carried out 8 weeks after coronary ligation or sham surgery under anesthesia. IMD and angiotensin II (Ang II) levels in the PVN were up-regulated in CHF rats. Bilateral PVN microinjection of IMD caused greater decreases in CSAR and the baseline RSNA and MAP in CHF rats than those in Sham rats. The decrease of CSAR caused by IMD was prevented by pretreatment with AM receptor antagonist AM22-52, but not CGRP receptor antagonist CGRP8-37. Ang II in the PVN significantly enhanced CSAR and superoxide anions level, which was inhibited by PVN pretreatment with IMD or tempol (a superoxide anions scavenger) in Sham and CHF rats. Conclusion: IMD in the PVN inhibits CSAR via AM receptor, and attenuates the effects of Ang II on CSAR and superoxide anions level in CHF rats. PVN superoxide anions involve in the effect of IMD on attenuating Ang II-induced CSAR response.

This article is from BMC Cardiovascular Disorders , volume 14 . Abstract Background: The objective of the SCHLA-HF registry is to investigate the prevalence of sleep-disordered breathing (SDB) in patients with chronic heart failure with reduced left ventricular systolic function (HF-REF) and to determine predictors of SDB in such patients. Methods: Cardiologists in private practices and in hospitals in Germany are asked to document patients with HF-REF into the prospective SCHLA-HF registry if they meet predefined inclusion and exclusion criteria. Screening was started in October 2007 and enrolment was completed at the end of May 2013. After enrolment in the registry, patients are screened for SDB. SDB screening is mainly undertaken using the validated 2-channel ApneaLink™ device (nasal flow and pulse oximetry; ResMed Ltd., Sydney, Australia). Patients with a significant number of apneas and hypopneas per hour recording time (AHI ≥15/h) and/or clinical symptoms suspicious of SDB will be referred to a cooperating sleep clinic for an attended in-lab polysomnography with certified scoring where the definite diagnosis and, if applicable, the differentiation between obstructive and central sleep apnea will be made. Suggested treatment will be documented. Discussion: Registries play an important role in facilitating advances in the understanding and management of cardiovascular disease. The SCHLA-HF registry will provide consistent data on a large group of patients with HF-REF that will help to answer questions on the prevalence, risk factors, gender differences and stability of SDB in these patients by cross-sectional analyses. Further insight into the development of SDB will be gained by extension of the registry to include longitudinal data.

This article is from The EPMA Journal , volume 5 . Abstract None

This article is from Pharmacy Practice , volume 8 . Abstract Guidelines have been published for management of chronic systolic heart failure to reduce patient morbidity and mortality.Objective: A quality review of the heart failure medical therapy for a community family medicine residency program clinic and a multidisciplinary heart failure specialty clinic was performed to compare adherence to ACC/AHA heart failure guidelines, with regard to medications and in titrating to recommended target doses. Methods: The study was a retrospective chart review and data collected included name and dose of any ACEI, beta-blocker, ARB, or other medication addressed in the guidelines. Results: Specialty clinic patients had significantly lower systolic blood pressures and ejection fractions. Significantly more patients were prescribed beta-blockers in the specialty clinic population (98% vs 80%, p

This article is from Arquivos Brasileiros de Cardiologia , volume 102 . Abstract Background: The treatment of heart failure has evolved in recent decades suggesting that survival is increasing. Objective: To verify whether there has been improvement in the survival of patients with advanced heart failure. Methods: We retrospectively compared the treatment and follow-up data from two cohorts of patients with systolic heart failure admitted for compensation up to 2000 (n = 353) and after 2000 (n = 279). We analyzed in-hospital death, re-hospitalization and death in 1 year of follow-up. We used Mann-Whitney U test and chi-square test for comparison between groups. The predictors of mortality were identified by regression analysis through Cox proportional hazards model and survival analysis by the Kaplan-Meier survival analysis. Results: The patients admitted until 2000 were younger, had lower left ventricular impairment and received a lower proportion of beta-blockers at discharge. The survival of patients hospitalized before 2000 was lower than those hospitalized after 2000 (40.1% vs. 67.4%; p

Aim: The relationship between elevated vitamin B12 levels and liver damage is well-established, but its association with the severity of heart failure (HF) remains unclear.

Early heart disease deaths rise to 14-year high British Heart Foundation 22/1/24 "The number of people dying before the age of 75 in England from heart and circulatory diseases has risen to the highest level in over a decade, according to our new analysis." Full presentation at 80% DISCOUNT Available here: Vaccine-Induced Abnormal Heart Physiology – Potential Mechanisms Register here: https://vejonhealth.learnworlds.com/abnormal-vaccinated-heart Read Article here: https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2024/january/early-heart-disease-deaths-rise-to-14-year-high Other Links: Substack - COVID-19: https://philipmcmillan.substack.com/ Patreon: https://patreon.com/VejonHealth Videos: https://mcmillanresearch.com/media/ Courses: https://mcmillanresearch.com/mr-education/ Substack - Long Covid: https://drphilipmcmillan.substack.com/ More info: https://vejonhealth.com/

In this short clip, Patrick Bet-David, Jimmy Dore, Adam Sosnick and Vincent Oshana react to Damar Hamlin not wanting to answer heart failure question. FaceTime or Ask Patrick any questions on https://minnect.com/ Watch the full podcast here: https://youtube.com/live/slvXEyzzX9A Subscribe to our channel: http://bit.ly/2aPEwD4 To reach the Valuetainment team, you can email: [email protected]

In this short clip, Patrick Bet-David, Jimmy Dore, Adam Sosnick and Vincent Oshana react to Damar Hamlin not wanting to answer heart failure question. FaceTime or Ask Patrick any questions on https://minnect.com/ Watch the full podcast here: https://youtube.com/live/slvXEyzzX9A Subscribe to our channel: http://bit.ly/2aPEwD4 To reach the Valuetainment team, you can email: [email protected]

1Esperanto Self-Taught with Phonetic Pronunciation, Volume 1

By William W. Mann

This is Volume 1 of William Mann’s “Esperanto Self-Taught with Phonetic Pronunciation”. It is part of a series of Self-Taught books written by various authors that include vocabularies of common words, elementary grammars and conversational phrases. The present volume contains thirty-seven vocabularies of common Esperanto words. If you want to learn Esperanto words or improve your Esperanto vocabulary, this volume may be of use to you. Mann writes, in the preface, that his work “supplies very full and comprehensive vocabularies of the words required by the tourist or traveller, visitor or resident abroad, health or pleasure seeker, and professional or business man, together with a large number of conversational sentences of a typical and practical character. The words and phrases are classified according to subject, and the phonetic pronunciation of every word is added in accordance with Marlborough's simple and popular system of phonetics. With the aid of this book anyone may undertake a trip to a foreign land, even if he know nothing of the language of the country he is going to, and, if he will put himself beforehand in communication with Esperantists in the various places he intends to visit, he will find them ready to help him in many ways, and his stay abroad will thus be made much more entertaining and instructive than if he had spent his time in the conventional manner of the ordinary tourist. A further great advantage of this international language is, that it opens up to the traveller, not merely one particular country, but the whole of Europe.”<BR><BR>(Summary by Nicholas James Bridgewater)<BR>For convenience, his book has been divided into 3 volumes in this audiobook version, the other 2 volumes will be recorded in the future.

2Esperanto Self-Taught with Phonetic Pronunciation, Volume 2

By William W. Mann

This is Volume 2 of William Mann’s “Esperanto Self-Taught with Phonetic Pronunciation”. It is part of a series of Self-Taught books written by various authors that include vocabularies of common words, elementary grammars and conversational phrases. The present volume contains an elementary grammar of Esperanto. If you want to understand Esperanto grammar, this volume may be of use to you. Mann writes, in the preface, that with “the aid of this book anyone may undertake a trip to a foreign land, even if he know nothing of the language of the country he is going to, and, if he will put himself beforehand in communication with Esperantists in the various places he intends to visit, he will find them ready to help him in many ways, and his stay abroad will thus be made much more entertaining and instructive than if he had spent his time in the conventional manner of the ordinary tourist. A further great advantage of this international language is, that it opens up to the traveller, not merely one particular country, but the whole of Europe.”

3Esperanto Self-Taught with Phonetic Pronunciation, Volume 3

By William W. Mann

Volume 3 of William Mann’s “Esperanto Self-Taught with Phonetic Pronunciation” is part of a series of Self-Taught books written by various authors that include vocabularies of common words, elementary grammars and conversational phrases. The present volume contains an conversational phrases in Esperanto. If you want to learn Esperanto phrases or improve your knowledge of conversational Esperanto, this volume may be of use to you. Mann writes, in the preface, that with “the aid of this book anyone may undertake a trip to a foreign land, even if he know nothing of the language of the country he is going to, and, if he will put himself beforehand in communication with Esperantists in the various places he intends to visit, he will find them ready to help him in many ways, and his stay abroad will thus be made much more entertaining and instructive than if he had spent his time in the conventional manner of the ordinary tourist. A further great advantage of this international language is, that it opens up to the traveller, not merely one particular country, but the whole of Europe.” (Introduction by Nicholas James Bridgewater)

4Present Picture of New South Wales

By David Dickinson Mann

Convicted of forgery at the age of 23, David Dickenson Mann narrowly escaped hanging and was transported instead to New South Wales, where he arrived in 1799. Three years later he received a full pardon and was soon working in the secretary's office of the colonial government. Mann fell foul of Governor William Bligh and was about to leave for England, but in 1808 found himself in favour with the rebel government that deposed him. The Present Picture of New South Wales, dedicated to the recently arrived Governor John Hunter, gives a detailed account of the colony . It includes a brief history, an A-Z encyclopedia of political and economic progress and Mann's own ideas on the future development of New South Wales. Mann returned to England in 1809, where he published his book in 1811, dying in the same year. - Summary by Phil Benson

5Royal Highness

By Thomas Mann

Royal Highness is the story of Prince Klaus Heinrich, a member of a struggling German duchy and an exotic American heiress who comes to live as his neighbor. The novel is a microcosm of Europe before World War I, with Mann's depiction of a decaying society that is rejuvenated by modern forces. A true modern day fairy tale. (Summary by Margaret Espaillat)

Horace Mann is called The Father of the Common School and was one of the first progressive thinkers on education in the United States. His <i>Annual Reports to the Massachusetts Board of Education</i>, written between 1837 and 1848, are wide-ranging essays on topics, including philosophical arguments on the role of education in a democracy, curricular matters such as textbook choice and methods of reading instruction, and nitty-gritty details of classroom furnishings and buildings. Even in the much-changed society of the 21st century, much of Mann's writing still speaks to us, recalling us to the roots of our faith in education for all. - Summary by Maria Kasper

7Bashan And I

By Thomas Mann

Simple and unpretentious as a statement by Francis d’Assisi, yet full of a gentle modern sophistication and humour, this little work will bring delight and refreshment to all who seek flight from the heavy-laden hour. It is, moreover, one of the most subtle and penetrating studies of the psychology of the dog that has ever been written—tender yet unsentimental, realistic and full of the detail of masterly observation and description, yet in its final form and precipitation a work of exquisite literary art. - Summary from the Foreword by Herman George Scheffauer

8Untertan

By Heinrich Mann

Der Untertan ist ein Roman von Heinrich Mann aus dem Jahr 1914. Die erste Buchausgabe erschien 1918 im Kurt Wolff Verlag. Heinrich Mann erzählt mit scharfem Witz die Lebensgeschichte des fiktiven Opportunisten und Karrieristen Diederich Heßling von dessen Kindheit bis hin zur Sicherung seiner Stellung in der wilhelminischen Gesellschaft des deutschen Kaiserreichs um die Jahrhundertwende vom 19. zum 20. Jahrhundert. Die Satire ist eine unverhohlene Kritik am Kaiserreich unter dem Regiment Wilhelms II., eine politische Kritik am kaiserfanatischen Bürgertum wie dem erschlafften Altliberalismus und eine Mentalitätsstudie über den autoritären Typus. Der Roman gilt als das wichtigste literarische Dokument über das Kaiserreich. Zeitgenossen und spätere Autoren wie Historiker erkannten im Untertan die mustergültige Zeichnung eines zeitgeistigen Männertypus und Darstellung der Vorgeschichte zum Ersten Weltkrieg. Als Gegenspieler des kaisertreuen Heßling ist der Honoratior Buck gezeichnet, ein Teilnehmer der Revolution von 1848, der durch Heßlings Ränke nicht nur den Verlust seiner Anhänger und das Ende der städtischen Bürgerlichkeit wie auch die Isolation seiner Familie, sondern den politischen Sieg der Kaisertreuen mit Hilfe korrupter Gewerkschafter erleben muss, ehe ihm auf dem Sterbebett ausgerechnet Heßling als der Leibhaftige vor der Türe erscheint. Der Untertan wird als Heinrich Manns größter Beitrag zur deutschen Literatur des 20. Jahrhunderts gewertet. (Wikipedia)

9Death in Venice

By Thomas Mann

Thomas Mann, author of Death in Venice (German: Der Tod in Venedig) was a winner of the Nobel Prize for literature. The main character in this novella is Gustav von Aschenbach, a famous author in his early 50s who was widowed at an early age. In poor health, he visits Venice and becomes increasingly obsessed by the sight of a stunningly beautiful lad of 14. This book has been acclaimed a masterpiece and in 1971 was adapted as a film starring Dirk Bogarde. (Summary by Lee Smalley)

When Thomas Mann was awarded the Nobel Prize in Literature (1929), the citation made special mention of his first novel, “Buddenbrooks,” published in 1901, describing it as “the first great novel of the 20th century.” <br><br> Events in the novel center on the Buddenbrook family, bourgeois owners of a wholesale grain enterprise in the northern German city of Lübeck. (The city is never named as such, but detailed references to landmarks leave no doubt that the setting is closely based on Mann’s hometown, just as the story is inspired by the Mann family history.) We follow four generations of Buddenbrooks through the middle decades of the 19th century. The novel is subtitled “The Decline of a Family.” This “decline” occurs through subtle interplay of character and circumstance. Family members — individuals each with their own romantic, social, and artistic interests — struggle to adapt to the expectations of the “family firm” and to the evolving conditions of German society in the 1800s. <br><br> Mann views his characters with both irony and intense empathy, propelling the reader’s journey through this momentous narrative. - Summary by Bruce Pirie

Thomas Mann’s epic novel depicts a decaying, corrupted European society on the eve of the First World War. Set in a luxurious sanatorium high up in the Swiss mountains, we follow the destinies of a variety of exotic characters – members of a bourgeois elite drawn from all parts of Europe. Most suffer from consumption, dream of a cure - yet are at the same time squeezing as much pleasure and distraction as they can out of a situation ever-shadowed by sickness, pain, and death. Part surreal comedy, part grim tragedy, part allegory, and part novel of ideas, Mann’s novel is regarded by many as one of the key literary texts of the twentieth century. Summary by Steve Gough

Thomas Mann’s epic novel depicts a decaying, corrupted European society on the eve of the First World War. Set in a luxurious sanatorium high up in the Swiss mountains, we follow the destinies of a variety of exotic characters – members of a bourgeois elite drawn from all parts of Europe. Most suffer from consumption, dream of a cure - yet are at the same time squeezing as much pleasure and distraction as they can out of a situation ever-shadowed by sickness, pain, and death. Part surreal comedy, part grim tragedy, part allegory, and part novel of ideas, Mann’s novel is regarded by many as one of the key literary texts of the twentieth century. - Summary by Steve Gough