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https://www.readbyqxmd.com/read/27909967/selective-blockade-of-%C3%AE-2-adrenoceptor-subtypes-modulates-contractility-of-rat-myocardium
#1
T L Zefirov, L I Khisamieva, N I Ziyatdinova, A L Zefirov
The study examined the dose-dependent effects of selective antagonists of α2A/D-, α2B-, and α2C- adrenoceptors applied in concentrations of 10(-9)-10(-5) M on atrial and ventricular contractility of rat myocardium in vitro. Selective blockade of each α2-adrenoceptor subtype affected the contractile force of the atrial and ventricular strips. Various concentrations of α2A/D- and α2C-adrenoceptor antagonists produced positive inotropic effect on ventricular strips and negative effect on atrial strips. α2B-Adrenoceptor blocker in the majority of the tested concentrations produced a positive inotropic effect in both atria and ventricles...
December 2, 2016: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/27909593/our-anaesthetic-experiences-in-patients-undergoing-percutaneous-mitraclip-implantation
#2
Ezgi Erkılıç, Elvin Kesimci, Cihan Döğer, Tülin Gümüş, Süleyman Ellik, Orhan Kanbak
OBJECTIVE: Percutaneous mitraclip implantation system, is a new technique developed for patients with high surgical risks. It is generally performed in a catheterisation laboratory with the guidance of fluoroscopy and transesophageal echocardiography. In this study, we aimed to share our experiences on anaesthetic in patients undergoing mitraclip implantation under general anaesthesia. METHODS: Eighty four patients with severe, symptomatic mitral insufficiency, who had undergone MitraClip implantation under general anaesthesia between July 2012 and March 2015 (54 male, 30 female; mean age: 68...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27908339/vasopressors-and-inotropes-in-sepsis
#3
REVIEW
Leeanne Stratton, David A Berlin, John E Arbo
Vasopressor and inotropes are beneficial in shock states. Norepinephrine is considered the first-line vasopressor for patients with sepsis-associated hypotension. Dobutamine is considered the first-line inotrope in sepsis, and should be considered for patients with evidence of myocardial dysfunction or ongoing signs of hypoperfusion. Vasopressor and inotrope therapy has complex effects that are often difficult to predict; emergency providers should consider the physiology and clinical trial data. It is essential to continually reevaluate the patient to determine if the selected treatment is having the intended result...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908328/the-new-usual-care
#4
REVIEW
Jared Radbel, Daniel Boutsikaris
Recent literature continues to refine which components of the early goal-directed therapy (EGDT) algorithm are necessary. Given it utilizes central venous pressure, continuous central venous oxygen saturation, routine blood transfusions, and inotropic medications, this algorithm can be timely, invasive, costly, and potentially harmful. New trials highlight early recognition, early fluid resuscitation, appropriate antibiotic treatment, source control, and the application of a multidisciplinary evidence-based approach as essential components of current sepsis management...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906545/temperature-dependent-inotropic-and-lusitropic-indices-based-on-half-logistic-time-constants-for-four-segmental-phases-in-isovolumic-left-ventricular-pressure-time-curve-in-excised-cross-circulated-canine-heart
#5
Ju Mizuno, Satoshi Mohri, Takeshi Yokoyama, Mikiya Otsuji, Hideko Arita, Kazuo Hanaoka
Varying temperature affects cardiac systolic and diastolic function and the left ventricular (LV) pressure-time curve (PTC) waveform that includes information about LV inotropism and lusitropism. Our proposed half-logistic (h-L) time constants obtained by fitting using h-L functions for four segmental phases (Phases I-IV) in the isovolumic LV PTC are more useful indices for estimating LV inotropism and lusitropism during contraction and relaxation periods than the mono-exponential (m-E) time constants at normal temperature...
September 5, 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#6
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#7
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27903222/sustained-elabela-gene-therapy-in-high-salt-induced-hypertensive-rats
#8
Claire A Schreiber, Sara J Holditch, Alex Generous, Yasuhiro Ikeda
BACKGROUND: Elabela (ELA) is a recently identified apelin receptor agonist essential for cardiac development, but its biology and therapeutic potential are unclear. In humans ELA transcripts are detected in embryonic stem cells, induced pluripotent stem cells, kidney, heart and blood vessels. ELA through the apelin receptor promotes angiogenesis in vitro, relaxes murine aortic blood vessels and attenuates high blood pressure in vivo. The apelin receptor when bound to its original ligand, apelin, exerts peripheral vasodilatory and positive inotropic effects, conferring cardioprotection in vivo...
November 21, 2016: Current Gene Therapy
https://www.readbyqxmd.com/read/27896834/histologic-alterations-in-tetralogy-of-fallot
#9
Safak Alpat, Mustafa Yilmaz, Sevgen Onder, Mustafa F Sargon, Murat Guvener, Riza Dogan, Metin Demircin, Ilhan Pasaoglu
BACKGROUND: This study was performed to investigate the pre-existing histologic alterations at the time of complete repair in patients with tetralogy of Fallot (TOF) and evaluate their effects on the early postoperative outcomes. METHODS: Fourteen patients, seven with acyanotic TOF (SO2  > 90, group I) and seven with cyanotic TOF (SO2  < 90, group II), undergoing complete repair, were enrolled. Right ventricular biopsies were examined for cardiomyocyte injury and fibrosis by light microscopy and mitochondrial injury by electron microscopy...
November 28, 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27895488/advances-in-the-management-of-heart-failure-the-role-of-ivabradine
#10
REVIEW
Ursula Müller-Werdan, Georg Stöckl, Karl Werdan
A high resting heart rate (≥70-75 b.p.m.) is a risk factor for patients with heart failure (HF) with reduced ejection fraction (EF), probably in the sense of accelerated atherosclerosis, with an increased morbidity and mortality. Beta-blockers not only reduce heart rate but also have negative inotropic and blood pressure-lowering effects, and therefore, in many patients, they cannot be given in the recommended dose. Ivabradine specifically inhibits the pacemaker current (funny current, If) of the sinoatrial node cells, resulting in therapeutic heart rate lowering without any negative inotropic and blood pressure-lowering effect...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#11
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27884411/celsior-versus-microplegia-analysis-of-myocardial-protection-in-elective-aortic-valve-replacement
#12
Jose López-Menéndez, Javier Miguelena, Carlos Morales, Carmen L Díaz, Francisco Callejo, Juan Carlos Llosa, Jacobo Silva
BACKGROUND: Previous studies have analyzed the efficacy of crystalloid cardioplegic solutions, but the use of Celsior (Genzyme Corp, Boston, MA) as a crystalloid cardioplegic solution has not been evaluated. METHODS: In this observational retrospective study, Celsior crystalloid solution was compared with an all-blood continuous myocardial protection (microplegia). The study included all patients who underwent elective aortic valve replacement operations in whom the myocardial protection was Celsior or microplegia...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27882023/effects-of-bisoprolol-in-combination-with-trimetazidine-on-the-treatment-of-heart-failure-and-concomitant-chronic-obstructive-pulmonary-disease
#13
Yuanyuan Ke, Dingli Xu, Minxiong Li, Zenglong Wu, Yongpeng Huang
OBJECTIVE: To evaluate the effects of bisoprolol combined with trimetazidine on the treatment of heart failure patients having concomitant chronic obstructive pulmonary disease (COPD); in comparison with control group treated with standard therapy only. METHODS: A total of 120 heart failure patients having concomitant COPD were selected and randomly divided into a control group and a treatment group according to different treatment methods (n=60). The control group was given continuous low flow oxygen inhalation and inotropic agents, and their cardiac stress was also reduced...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27879559/angiotensin-ii-in-refractory-septic-shock
#14
Elio Antonucci, Patrick J Gleeson, Filippo Annoni, Sara Agosta, Sergio Orlando, Fabio Silvio Taccone, Dimitrios Velissaris, Sabino Scolletta
Refractory septic shock is defined as persistently low mean arterial blood pressure despite volume resuscitation and titrated vasopressors/inotropes in patients with a proven or suspected infection and concomitant organ dysfunction. Its management typically requires high doses of catecholamines, which can induce significant adverse effects such as ischemia and arrhythmias. Angiotensin II (Ang II), a key product of the renin-angiotensin-aldosterone system (RAAS), is a vasopressor agent that could be used in conjunction with other vasopressors to stabilize critically ill patients during refractory septic shock, and reduce catecholamine requirements...
November 21, 2016: Shock
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#15
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27875721/percutaneous-mitral-valve-repair-the-last-chance-for-symptoms-improvement-in-advanced-refractory-chronic-heart-failure
#16
Alessandra Berardini, Elena Biagini, Francesco Saia, Davide Stolfo, Mario Previtali, Francesco Grigioni, Bruno Pinamonti, Gabriele Crimi, Alessandro Salvi, Maurizio Ferrario, Antonio De Luca, Fabrizio Gazzoli, Maria Letizia Bacchi Reggiani, Claudia Raineri, Gianfranco Sinagra, Claudio Rapezzi
BACKGROUND: The role of percutaneous mitral valve repair (PMVR) in patients with end-stage heart failure (HF) and functional mitral regurgitation (FMR) is unclear. METHODS: Seventy-five consecutive patients with FMR grade≥3+ and severe HF symptoms despite optimal medical therapy and resynchronization therapy underwent PMVR with the MitraClip system (Abbott, Abbott Park, IL, USA) at 3 centers. Clinical evaluation, echocardiography and pro-BNP measurement were performed at baseline and at 6-month...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27875283/does-persistent-inflammatory-catabolic-syndrome-exist-in-critically-ill-neonates
#17
Nicole Ellis, Caitlin Hughes, Vera Mazurak, Chloe Joynt, Bodil Larsen
BACKGROUND: Persistent inflammatory catabolic syndrome (PICS) has not been described in the infant population. This study proposes a definition of PICS in critically ill infants. METHODS: A published adult criterion of PICS was modified using anthropometric and biochemical reference ranges for infants. A prospective chart review of admissions to a tertiary surgical neonatal intensive care unit (NICU) was performed over 65 days. Demographic, anthropometric, biochemical, and other clinical variables such as length of stay and medication use were collected daily throughout admission...
October 10, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27872804/pulmonary-hypertension-secondary-to-pulmonary-veno-occlusive-disease-complicated-by-right-heart-failure-hypotension-and-acute-kidney-injury
#18
Nima Golzy, Stuti Fernandes, Justin Sharim, Rikin Tank, Henry D Tazelaar, Howard E Epstein, Victor Tapson, Antoine Hage
Pulmonary veno-occlusive disease (PVOD) is rare condition which can lead to severe pulmonary hypertension, right ventricular dysfunction, and cardiopulmonary failure. The diagnosis of PVOD can be challenging due to its nonspecific symptoms and its similarity to idiopathic pulmonary arterial hypertension and interstitial lung disease in terms of diagnostic findings. This case describes a 57 year old female patient who presented with a 5-month history of progressive dyspnea on exertion and nonproductive cough...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27869900/-transient-left-ventricular-apical-ballooning-with-dynamic-outflow-tract-obstruction-complicated-by-persistent-hypotension
#19
Rodolfo Pino, Faro Manzella, Danilo Puccio, Giuseppa Sciortino, Giovanni Polizzi
The pathogenesis of tako-tsubo syndrome remains, nowadays, unclear: it is likely that the relevance of the different proposed mechanisms differs among specific clinical contexts. In this paper, we describe the case of a 61-year-old woman admitted to the intensive cardiac care unit for pre-syncope and persistent hypotension. Clinical and echocardiographic data were suggestive of tako-tsubo syndrome with severe dynamic left ventricular outflow tract (LVOT) obstruction and severe mitral regurgitation. Coronary angiography was normal...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#20
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
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