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https://www.readbyqxmd.com/read/28101622/-use-of-vasopressors-and-inotropics-in-cardiogenic-shock
#1
H Lemm, S Dietz, M Janusch, M Buerke
Vasoactive drugs and inotropic agents are important for the hemodynamic management of cardiogenic shock. In this article the use of different vasoactive and ionotropic drugs in cardiogenic shock is presented. Hemodynamic management during cardiogenic shock occurs after initial moderate volume delivery by dobutamine to increase inotropism. If adequate perfusion pressures are not achieved norepinephrine is administered. If a sufficient increase in cardiac performance can still not be achieved by the treatment, administration of levosimendan or phosphodiesterase (PDE) inhibitors may be necessary...
January 18, 2017: Herz
https://www.readbyqxmd.com/read/28099588/dobutamine-stress-echocardiography-safety-in-chagas-disease-patients
#2
Daniela do Carmo Rassi, Marcelo Luiz Campos Vieira, Rogerio Gomes Furtado, Fabio de Paula Turco, Luciano Henrique Melato, Viviane Tiemi Hotta, Colandy Godoy de Oliveira Nunes, Luiz Rassi, Salvador Rassi
Background: A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease...
January 16, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28091873/prediction-of-left-ventricular-contractile-recovery-using-tissue-doppler-strain-and-strain-rate-measurements-at-rest-in-patients-undergoing-percutaneous-coronary-intervention
#3
Ihab M Abdelgawwad, Ahmed A Al Hawary, Hanan M Kamal, Layla M Al Maghawry
The aim of the study was to assess the ability of tissue Doppler (TD) deformation analysis at rest to predict left ventricular contractile recovery in patients undergoing percutaneous coronary intervention (PCI). This prospective cohort enrolled 67 patients with segmental wall motion abnormality. Assessment of each segment was performed at rest and during low dose Dobutamine stress echocardiography (DSE) using a 4 point scoring system, TD peak systolic strain (PSS) and peak systolic strain rate (PSSR). The study followed up the patients for contractile improvement after 6 months of successful PCI by echocardiography...
January 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28087308/myocardial-inotropic-reserve-an-old-twist-that-constitutes-a-reliable-index-in-the-modern-era-of-heart-failure
#4
REVIEW
Fragkiskos Parthenakis, Spyridon Maragkoudakis, Maria Marketou, Alexandros Patrianakos, Evaggelos Zacharis, Panos Vardas
Current national and international guidelines, including those of the European Society of Cardiology, recognize that the assessment of prognosis should be a part of the standard management for patients with chronic heart failure (CHF). However, these same guidelines recognize the inherent difficulty of this process. A variety of factors contribute to this difficulty, including the varying etiology, frequent co-morbidity and, perhaps most importantly, huge inter-individual variability in the disease progression and outcome...
November 22, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28079557/dobutamine-aggravates-haemodynamic-deterioration-induced-by-pleural-effusion-a-randomised-controlled-porcine-study
#5
Kristian B Wemmelund, Anders H Sørensen, Viktor K Ringgård, Erik Sloth, Peter Juhl-Olsen
BACKGROUND: Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. OBJECTIVE: We hypothesised that dobutamine would affect the physiological determinants preload, afterload, contractility and changes of inferior vena cava characteristics during experimental pleural effusion. DESIGN: A randomised, controlled laboratory study. SETTING: Animal laboratory, conducted from March 2013 to May 2013...
January 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28072739/risk-factors-and-outcomes-associated-with-a-higher-use-of-inotropes-in-kidney-transplant-recipients
#6
Jae Moon Choi, Jun-Young Jo, Jae-Won Baik, Sooyoung Kim, Chan Sik Kim, Sung-Moon Jeong
Preservation of adequate perfusion pressures to the graft is a main focus of intraoperative management during kidney transplantation. We undertook this study to investigate the incidence of the higher use of inotropes in kidney transplant recipients and identify the patient outcomes and preoperative and intraoperative variables related to this.We retrospectively analyzed 1053 patients who underwent kidney transplantation at Asan Medical Center between January 2006 and February 2012, stratified by their inotropic score ([dopamine] + [dobutamine] + [epinephrine × 100] + [norepinephrine × 100]) <7 versus ≥7, wherein all doses are expressed as μg/kg/min...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071680/loss-of-tricellular-tight-junction-protein-lsr-promotes-cell-invasion-and-migration-via-upregulation-of-tead1-areg-in-human-endometrial-cancer
#7
Hiroshi Shimada, Shyuetsu Abe, Takayuki Kohno, Seiro Satohisa, Takumi Konno, Syunta Takahashi, Tsubasa Hatakeyama, Chihiro Arimoto, Takuya Kakuki, Yakuto Kaneko, Ken-Ichi Takano, Tsuyoshi Saito, Takashi Kojima
Lipolysis-stimulated lipoprotein receptor (LSR) is a unique molecule of tricellular contacts of normal and cancer cells. We investigated how the loss of LSR induced cell migration, invasion and proliferation in endometrial cancer cell line Sawano. mRNAs of amphiregulin (AREG) and TEA domain family member 1 (TEAD1) were markedly upregulated by siRNA-LSR. In endometrial cancer tissues, downregulation of LSR and upregulation of AREG were observed together with malignancy, and Yes-associated protein (YAP) was present in the nuclei...
January 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28068900/galectin-3-and-fibulin-1-in-systolic-heart-failure-relation-to-glucose-metabolism-and-left-ventricular-contractile-reserve
#8
Pernille Holmager, Michael Egstrup, Ida Gustafsson, Morten Schou, Jordi S Dahl, Lars Melholt Rasmussen, Jacob E Møller, Christian Tuxen, Jens Faber, Caroline Kistorp
BACKGROUND: Heart failure (HF) patients with diabetes (DM) have an adverse prognosis and reduced functional capacity, which could be associated with cardiac fibrosis, increased chamber stiffness and reduced left ventricular (LV) contractile reserve. Galectin-3 (Gal-3) and fibulin-1 are circulating biomarkers potentially reflecting cardiac fibrosis. We hypothesize that plasma levels of Gal-3 and fibulin-1 are elevated in HF patients with DM and are associated with reduced LV contractile reserve in these patients...
January 10, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28065654/challenging-cardiac-function-post-spinal-cord-injury-with-dobutamine
#9
Kathryn M DeVeau, Emily K Martin, Nicholas T King, Alice Shum-Siu, Bradley B Keller, Christopher R West, David S K Magnuson
There is general consensus that spinal cord injuries (SCI) above T6 result in altered sympathetic control of the heart, which negatively influences cardiac structure and function. To by-pass disrupted circuitry and investigate cardiac responses under enhanced sympathetic activity we utilized dobutamine (DOB) stress echocardiography. Animals were divided into a T2, 25g-cm contusive SCI (SCI) or an uninjured control (CON) group. Echocardiography was performed pre-SCI and at 1, 2 and 6weeks post-SCI. Increasing doses of DOB (5, 10 & 20μg/min/kg) were infused intravenously pre-SCI and at 1 and 6weeks post-SCI...
December 23, 2016: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28043677/pressure-volume-loop-derived-cardiac-indices-during-dobutamine-stress-a-step-towards-understanding-limitations-in-cardiac-output-in-children-with-hypoplastic-left-heart-syndrome
#10
James Wong, Kuberan Pushparajah, Adelaide de Vecchi, Bram Ruijsink, Gerald F Greil, Tarique Hussain, Reza Razavi
BACKGROUND: Children with a single systemic right ventricle, such as in hypoplastic left heart syndrome (HLHS), frequently experience reduced exercise capacity. Elucidating the causes could help with optimising treatment strategies. METHODS: Prospective data from 10 consecutive symptomatic patients with HLHS undergoing clinical cardiac magnetic resonance with catheterisation (XMR) were analysed. Mean age 8.6years (range 3.5-11.6years), mean time since Fontan completion 5...
December 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28018821/pimobendan-in-chronic-right-heart-failure-in-a-left-ventricular-assist-device-patient
#11
Maximilian Kreibich, Michael Berchtold-Herz, Friedhelm Beyersdorf, Georg Trummer
We report the case of a 76-year-old patient who developed chronic right heart failure 1 year after left ventricular assist device implantation due to ischemic cardiomyopathy. Initial recompensation was achieved through dobutamin, sildenafil, and levosimendan treatment. Yet, discharge was successful only after the off-label use of the oral calcium sensitizer pimobendan. Ten months after discharge, the patient presents with no clinical signs of right heart failure and significantly improved right heart function without any impairment in quality of life...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28017781/inotropic-support-against-early-brain-injury-improves-cerebral-hypoperfusion-and-outcomes-in-a-murine-model-of-subarachnoid-hemorrhage
#12
Tomoko Mutoh, Tatsushi Mutoh, Kazuhiro Nakamura, Kazumasu Sasaki, Yasuko Tatewaki, Tatsuya Ishikawa, Yasuyuki Taki
Early brain injury/ischemia is a recent therapeutic target that contributes to triggering delayed cerebral ischemia (DCI) in the setting of subarachnoid hemorrhage (SAH). This study aimed to determine the role of dobutamine for inotropic cardiac support in improving cerebral blood flow (CBF) and outcomes after experimental SAH, mediated by hypoxia-inducible factor (HIF). Thirty-one mice were subjected to SAH by endovascular perforation, and assigned to either 2% isoflurane postconditioning performed between 1 and 2...
December 23, 2016: Brain Research Bulletin
https://www.readbyqxmd.com/read/27999826/the-diagnosis-of-silent-myocardial-ischemia-motion-frozen-or-morphing-myocardial-perfusion-imaging
#13
EDITORIAL
Cheng Chang, Bo Ye, Wenhui Xie, Daoliang Zhang, Bei Lei, Xiaodan Ye
Silent myocardial ischemia is typically defined as objective evidence of myocardial ischemia in patients without subjective ischemia symptoms. Currently, coronary artery angiography is the gold standard for diagnosis of asymptomatic coronary artery disease (CAD). Computed tomography coronary angiography (CTCA) can visually demonstrate the morphology, trend and extent of coronary stenosis and is commonly used in clinical screening of CAD. Myocardial perfusion imaging can be used not only to identify whether anatomical stenosis causes myocardial dysfunction, but to also assess the risk stratification and prognosis of myocardial disease (MD)...
September 2016: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/27998611/bilateral-sympathectomy-improves-postinfarction-left-ventricular-remodeling-and-function
#14
Fernando Luiz Zanoni, Rafael Simas, Raphael Grillo da Silva, Ana Cristina Breithaupt-Faloppa, Raphael Dos Santos Coutinho E Silva, Fábio Biscegli Jatene, Luiz Felipe P Moreira
OBJECTIVES: To evaluate the influence of bilateral or left sympathectomy on left ventricular remodeling and function after myocardial infarction in rats. METHODS: Myocardial infarction was induced in rats by ligation of the left anterior descending coronary. Seven days later, rats were divided into 4 groups: the myocardial infarction, myocardial infarction with left sympathectomy, myocardial infarction with bilateral sympathectomy, and sham groups. After 8 weeks, left ventricular function was evaluated with the use of a pressure-volume conductance catheter under steady-state conditions and pharmacological stress...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27989054/contribution-of-dobutamine-stress-echocardiography-to-the-diagnosis-and-prognosis-of-low-flow-low-gradient-aortic-stenosis
#15
Sílvia Aguiar Rosa, Luísa Moura Branco, Ana Galrinho, Guilherme Portugal, Joäo Abreu, Duarte Cacela, José Fragata, Rui Cruz Ferreira
BACKGROUND: Aortic valve replacement (AVR) is the treatment of choice in patients with severe symptomatic aortic stenosis (AS). Patients with a low left ventricular ejection fraction (LVEF) represent a challenge for evaluation and therapeutic decision. Dobutamine stress echocardiography (DSE) allows the distinction to be made between fixed low-flow/low-gradient (LF/LG) AS and pseudosevere AS. METHODS: Between 2001 and 2014 a retrospective analysis was conducted of patients who underwent DSE to investigate severe AS...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27984428/%C3%AE-adrenergic-responsiveness-in-the-type-2-diabetic-heart-effects-on-cardiac-reserve
#16
Genevieve A Wilson, Luke C Wilson, Regis R Lamberts, Kamran Majeed, Sudish Lal, Gerard T Wilkins, James C Baldi
: Type 2 diabetes (T2D) is associated with reduced cardiac reserve and aerobic capacity. Altered myocardial autonomic nervous regulation has been demonstrated in humans with diabetes (indirectly) and animal models (directly). PURPOSE: To determine the chronotopic and inotropic response of the type 2 diabetic heart to β-adrenergic stimulation. METHODS: 8 people with uncomplicated type 2 diabetes and 7 matched controls performed a DEXA scan and V[Combining Dot Above]O2peak test...
December 14, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27983541/effect-of-increasing-mean-arterial-blood-pressure-on-microcirculation-in-patients-with-cardiogenic-shock-supported-by-extracorporeal-membrane-oxygenation
#17
Zhongtao Du, Zaishen Jia, Jinhong Wang, Zhichen Xing, Chunjing Jiang, Bo Xu, Xiaofang Yang, Feng Yang, Na Miao, Jialin Xing, Hong Wang, Ming Jia, Xiaotong Hou
BACKGROUND: Little is known about the effect of mean arterial blood pressure (MAP) augmentation on the microcirculation in cardiogenic-shock patients with peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support. We investigated the effect of increasing MAP on the microcirculation in cardiogenic-shock patients with ECMO support. METHODS: A single-center prospective observational study under taken in ICU patients undergoing ECMO support for post-cardiotomy cardiogenic shock was carried out...
December 14, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27982343/intraoperative-analysis-of-flow-dynamics-in-arteriovenous-composite-y-grafts
#18
Heraldo Guedis Lobo, José Glauco Lobo, Matheus Duarte Pimentel, Bruno Gadelha Bezerra Silva, Camylla Santos de Souza, Marília Leitão Montenegro, Maria Cláudia de Azevedo Leitão, Francisco Vagnaldo Fechine Jamacuru
Objective: Composite graft of left internal thoracic artery and great saphenous vein in revascularization of the left coronary system is a technique well described in literature. The aim of this study is to analyze blood flow dynamics in this configuration of composite graft especially in what concerns left internal thoracic artery's adaptability and influence of great saphenous vein segment on left internal thoracic artery's flow. Methods: Revascularization of left coronary system with composite graft, with left internal thoracic artery revascularizing the anterior interventricular artery and a great saphenous vein segment, anastomosed to the left internal thoracic artery, revascularizing another branch of the left coronary system, was performed in 23 patients...
September 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27958262/role-of-low%C3%A2-dose-dobutamine-echocardiography-in-predicting-response-to-biventricular-pacing-results-from-the%C3%A2-multicenter-viability-in-cardiac-resynchronisation-therapy-viacrt-study
#19
Edyta Płońska-Gościniak, Jarosław D Kasprzak, Tomasz Kukulski, Katarzyna Mizia-Stec, Ewa Nowalany-Kozielska, Zbigniew Gąsior, Krystian Wita, Władysław Sinkiewicz, Hanna Szwed, Piotr Gościniak, Łukasz Chrzanowski
INTRODUCTION    The response to Cardiac Resynchronisation Therapy (CRT) varies significantly, resulting in lack of improvement among the substantial patients proportion.  OBJECTIVES    To identify mechanical dyssynchrony indices with combination of myocardial viability characteristics for predicting long-term response to CRT.  PATIENTS AND METHODS    ViaCRT was a multicentre study coordinated by the Working Group on Echocardiography of  Polish Cardiac Society. 127 patients with heart failure were assessed prospectively...
December 12, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27939502/magnetic-resonance-imaging-assessment-of-cardiac-function-in-a-swine-model-of-hibernating-myocardium-3%C3%A2-months-following-bypass-surgery
#20
Laura L Hocum Stone, Cory Swingen, Christopher Holley, Christin Wright, Erin Chappuis, Herbert B Ward, Edward O McFalls, Rosemary F Kelly
OBJECTIVE: Clinical studies demonstrate delayed recovery of hibernating myocardium (HM) following coronary artery bypass graft (CABG) surgery. Cardiac magnetic resonance (CMR) imaging is effective in identifying HM in clinical settings. Our animal model of HM shows partial but incomplete functional recovery 1 month following CABG using echocardiography. This study uses CMR imaging to determine completeness of recovery 3 months post-CABG. METHODS: Swine (N = 12) underwent left anterior descending artery (LAD) 1...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
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