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Aim: Balloon pulmonary angioplasty (BPA) has recently been established as an effective therapy for peripheral‐type chronic thromboembolic pulmonary hypertension (CTEPH). However, the safety and effectiveness of BPA in elderly patients with CTEPH have not been clarified. Methods: A total of 19 patients with CTEPH who underwent BPA were recruited. The patients were assigned to groups by age, <70 years (non‐elderly; n = 11) and ≥70 years (elderly; n = 8). Hemodynamic parameters, right ventricular function and plasma N‐terminal pro‐brain natriuretic peptide were assessed before and after BPA, and complications arising after BPA were also evaluated. Results: Hemodynamic parameters and right heart function did not differ significantly between the two groups at baseline. BPA significantly improved pulmonary arterial pressure, pulmonary vascular resistance and fractional area change in both groups (all P < 0.05), although the differences were comparable. No fatal complications developed, but the frequency of minor complications, such as transient hemoptysis, was higher in the elderly group than in the non‐elderly group (median 0.45 [interquartile range 0.27–0.63] vs 0 [0–0.33], respectively; P = 0.021). The frequency of such complications was also higher in patients with a psychiatric disorder than in those without (0.50 [0.44–1.00] vs 0.14 [0–0.33], respectively; P = 0.006). Multivariate regression analysis identified higher age, baseline N‐terminal pro‐brain natriuretic peptide values and an underlying psychiatric disorder as significant predictors of complications of BPA. Conclusions: BPA is an effective treatment for peripheral‐type CTEPH regardless of age; however, higher age, N‐terminal pro‐brain natriuretic peptide values before treatment and an underlying psychiatric disorder might be associated with minor complications. Geriatr Gerontol Int 2018; 18: 678–684 [ABSTRACT FROM AUTHOR]

The article presents a case study of a 85 year old woman who underwent a nephrostomy for right hydronephrosis. It notes that after the surgery she suffered acute heart failure and several tests revealed that she was diagnosed with midventricular Takotsubo (or stress-induced) cardiomyopathy (TC). The article discusses that the patient's condition improved due to the infusion of landiolol and was released from the hospital after two days.

Aim We evaluated the effect of pimobendan, a positive inotropic agent, in elderly patients with frequent readmission as a result of heart failure despite conventional therapy. Methods Pimobendan was given to five male patients with severe chronic heart failure ( New York Heart Association class III- IV) (age range 69-89 years; mean 78 ± 8 years; ischemic cardiomyopathy in three cases, dilated cardiomyopathy in two cases) who required repeated admission for heart failure despite conventional therapy with angiotensin inhibitors, beta-blockers, diuretics and anti-arrhythmic agents. After the addition of pimobendan at a dose of 1.25-3.75 mg/day, we evaluated serum levels of brain natriuretic peptide ( BNP), left ventricular ejection fraction ( LVEF), septal e′ and left ventricular end-diastolic diameter ( LVDD) by echocardiography, as well as readmission rates for more than 2 years. Results The serum level of BNP significantly decreased after treatment with pimobendan, although its level returned to pretreatment levels after 2 years. LVEF significantly improved after the treatment, with the improvement continuing beyond the 2 years, although LVDD did not change after treatment. Septal e′ significantly improved after the treatment, although its level returned to pretreatment levels at 2 years after the treatment. Readmission rates significantly decreased for 2 years after the treatment, although one patient required cardiac resynchronization therapy for severe heart failure, and another patient required cardiac pacemaker implantation for sick sinus syndrome 2 years after adding pimobendan. Conclusions Pimobendan in conjunction with conventional therapy for heart failure decreases the readmission rate in elderly patients with severe heart failure for at least 2 years. Geriatr Gerontol Int 2014; 14: 109-114. [ABSTRACT FROM AUTHOR]