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Aniruddha Vyas, Neeta Bachani, Hrishikesh Thakur, Yash Lokhandwala
"Digitalis toxicity, often candidly indexed as poisoning, has plagued the medical profession for over 200 years. The situation qualifies as a professional disgrace on the basis of three items: the situation persists, physicians are often slow to recognize it and, over the decades, writers have been harsh in their denunciation of fellow physicians when toxicity has occurred…." These are the opening remarks of an essay published in 1983 on the 2nd centenary of William Withering's 'magic potion from foxglove's extract for dropsy...
September 2016: Indian Heart Journal
Ekaterina V Lopatina, Anna V Kipenko, Natalia A Pasatetskaya, Valentina A Penniyaynen, Boris V Krylov
Endogenous digitalis-like factors were found in the mammalian and human blood. It was the starting point for the elucidation of the new non-pumping function of the Na(+),K(+)-ATPase. It was previously well known that Na(+),K(+)-ATPase is a pharmacological target receptor for cardiac glycosides (J.C. Skou. 1957. Biochim. Biophys. Acta, 23: 394-401). We have investigated the trophotropic effects of such agents as ouabain, epinephrine, norepinephrine, atenolol, and comenic acid using the organotypic tissue culture combined with the reconstruction of optical cross sections and confocal microscopy...
October 2016: Canadian Journal of Physiology and Pharmacology
Naoki Okumura, Pardeep S Jhund, Jianjian Gong, Martin P Lefkowitz, Adel R Rizkala, Jean L Rouleau, Victor C Shi, Karl Swedberg, Michael R Zile, Scott D Solomon, Milton Packer, John J V McMurray
BACKGROUND: In the PARADIGM-HF trial (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure), the angiotensin receptor neprilysin inhibitor sacubitril/valsartan was more effective than the angiotensin-converting enzyme inhibitorenalapril in patients with heart failure and reduced ejection fraction. We examined whether this benefit was consistent irrespective of background therapy. METHODS AND RESULTS: We examined the effect of study treatment in the following subgroups: diuretics (yes/no), digitalis glycoside (yes/no), mineralocorticoid receptor antagonist (yes/no),and defibrillating device (implanted defibrillating device, yes/no)...
September 2016: Circulation. Heart Failure
Wissam Alajaji, Atallah Baydoun, Sadeer G Al-Kindi, Leslie Henry, Mazen A Hanna, Guilherme H Oliveira
OBJECTIVE: Right heart failure is associated with increased mortality and morbidity. The optimal treatment for patients with RV failure is not established. The aim of this study is to conduct a systematic review of the literature to assess the relative benefits and harms of digoxin therapy in patients with RV failure. METHODS: We performed a literature search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) on Nov. 4, 2014. We did not use publication type, period or language restrictions to the search strategy...
November 15, 2016: International Journal of Cardiology
Julia W Erath, Mate Vamos, Stefan H Hohnloser
AIMS: The effects of digitalis on mortality in patients with structural heart disease are controversially discussed. We aimed to assess the effects of digitalis administration in implantable cardioverter defibrillator (ICD) recipients. METHODS AND RESULTS: This retrospective analysis comprises 1020 consecutive patients who received an ICD at our institution and who were followed for up to 10 years (median 37 months). A total of 438 patients were receiving digitalis at the time of ICD implantation and 582 did not...
July 2016: European Heart Journal. Cardiovascular Pharmacotherapy
Kirkwood F Adams, Javed Butler, J Herbert Patterson, Wendy Gattis Stough, Jerry L Bauman, Dirk J van Veldhuisen, Todd A Schwartz, Hani Sabbah, John I Mackowiak, Hector O Ventura, Jalal K Ghali
AIMS: Many patients with heart failure and reduced EF remain at high risk for hospitalization despite evidence-based therapy. Digoxin may decrease hospitalization; however, uncertainty persists concerning its proper administration and effect on mortality. This study investigated whether using dose response concepts to re-evaluate the relationship between serum digoxin concentration and key mortality outcomes in patients with reduced EF in the Digitalis Investigation Group trial would help clarify efficacy and safety...
August 2016: European Journal of Heart Failure
Praloy Chakraborty, Bhavna Kaul, Kausik Mandal, H S Isser, Sandeep Bansal, Anandaraja Subramanian
Bidirectional ventricular tachycardia (BDVT) is a rare form of ventricular arrhythmia, characterized by changing QRS axis of 180 degrees. Digitalis toxicity is considered as commonest cause of BDVT; other causes include aconite toxicity, myocarditis, myocardial infarction, metastatic cardiac tumour and cardiac channelopathies. We describe a case of BDVT in a patient with Anderson-Tawil syndrome.
November 2015: Indian Pacing and Electrophysiology Journal
Esteban Orenes-Piñero, Mariano Valdés, Gregory Y H Lip, Francisco Marín
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is associated with decreased quality of life, and increased mortality and morbidity from stroke and thromboembolism. The underlying mechanisms involved in the development of AF have yet to be fully elucidated. However, once initiated, AF tends to self-perpetuate, due to structural and electrical remodeling in the atria. Currently, therapies for AF, such as, antiarrhythmic drugs and catheter ablation, have significant limitations...
August 2015: Drug Metabolism Reviews
Alon Eisen, Christian T Ruff, Eugene Braunwald, Francesco Nordio, Ramón Corbalán, Anthony Dalby, Maria Dorobantu, Michele Mercuri, Hans Lanz, Howard Rutman, Stephen D Wiviott, Elliott M Antman, Robert P Giugliano
BACKGROUND: Recent findings suggest that atrial fibrillation is associated with sudden cardiac death (SCD). We examined the incidence, characteristics, and factors associated with SCD in patients with atrial fibrillation. METHODS AND RESULTS: SCD was defined as witnessed death ≤60 minutes from the onset of new symptoms or unwitnessed death 1 to 24 hours after being observed alive, without another known cause of death. Predictors of SCD were examined using multivariate competing risks models...
July 2016: Journal of the American Heart Association
Konstantinos Karatolios, Volker Holzendorf, Anette Richter, Bernhard Schieffer, Sabine Pankuweit
BACKGROUND: The study objectives were to identify predictors of outcome and to assess the long-term outcome in patients with non-ischemic dilated cardiomyopathy (DCM). METHODS AND RESULTS: From 2004 to 2008, 206 consecutive patients (age 52.1±12.6years) with non-ischemic DCM were prospectively enrolled in the study and followed up for a mean of 55.6±18.4months. Predictors of outcome were identified in a multivariable analysis with a Cox proportional hazards analysis...
October 1, 2016: International Journal of Cardiology
Sandeep Kumar Verma, Gunce Sahin, Ekrem Gurel
Digitalis davisiana, commonly called Alanya foxglove, from Turkey, is an important medicinal herb as the main source of cardiac glycosides, cardenolides, anthraquinones, etc. It is also known in the Indian Medicine for treatment of wounds and burns. It has ornamental value as well. Overexploitation of D. davisiana has led this species to be declared protected, and thereby encouraged various methods for its propagation. In this study, an optimized and efficient plant tissue culture protocol was established using cotyledonary leaf, hypocotyl and root explants of D...
April 2016: Indian Journal of Experimental Biology
Syevda G Sirenko, Victor A Maltsev, Yael Yaniv, Rostislav Bychkov, Daniel Yaeger, Tatiana Vinogradova, Harold A Spurgeon, Edward G Lakatta
Coupling of an intracellular Ca(2+) clock to surface membrane ion channels, i.e., a "membrane clock, " via coupling of electrochemical Na(+) and Ca(2+) gradients (ENa and ECa, respectively) has been theorized to regulate sinoatrial nodal cell (SANC) normal automaticity. To test this hypothesis, we measured responses of [Na(+)]i, [Ca(2+)]i, membrane potential, action potential cycle length (APCL), and rhythm in rabbit SANCs to Na(+)/K(+) pump inhibition by the digitalis glycoside, digoxigenin (DG, 10-20 μmol/l)...
July 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Bert Vandenberk, Christophe Garweg, Gabor Voros, Vincent Floré, Thomas Marynissen, Christian Sticherling, Markus Zabel, Joris Ector, Rik Willems
BACKGROUND: Clinical guidelines on implantable cardioverter defibrillator (ICD) therapy changed significantly in the last decades with potential inherent effects on therapy efficacy. We aimed to study therapy rates in time and the association between therapies and mortality. METHODS: All patients receiving an ICD, primary and secondary prevention, were included in a single-center retrospective registry. Information on first appropriate and inappropriate therapies was documented...
August 2016: Pacing and Clinical Electrophysiology: PACE
Oliver J Ziff, Dipak Kotecha
After 230 years of use, digitalis remains an important and useful therapy for patients with atrial fibrillation, heart failure, and the 30-50 % of patients with both conditions. Although the combination of positive inotropic activity with negative chronotropic effects has been shown to reduce hospital admissions in heart failure, there is a distinct lack of robust trial data, particularly in patients with atrial fibrillation. We recently performed a comprehensive meta-analysis of all digoxin studies and demonstrated a neutral effect on mortality...
October 2016: Trends in Cardiovascular Medicine
Aneta Paczula, Andrzej Więcek, Grzegorz Piecha
Endogenous cardiotonic steroids (CTS), also called digitalis-like factors, are a group of steroid hormones linking high salt intake and elevated blood pressure and in part responsible for target organ damage in arterial hypertension. CTS act primarily through their ability to inhibit the ubiquitous transport enzyme sodium-potassium adenosine triphosphatase (Na⁺/K⁺-ATPase). A portion of Na⁺/K⁺-ATPase does not seem to actively "pump" sodium and potassium but is closely associated with other key signaling proteins...
March 18, 2016: Postȩpy Higieny i Medycyny Doświadczalnej
Naivy Pérez-Alonso, Borys Chong-Pérez, Alina Capote, Anabel Pérez, André Gerth, Geert Angenon, Elio Jiménez
Digitalis purpurea L. is one of the main economically viable sources of cardenolides (cardiac glycosides) for the pharmaceutical industry. Nevertheless, production of cardenolides in plants grown by traditional agriculture is not always an efficient process and can be affected by biotic and abiotic factors. This chapter provides two biotechnology strategies for biomass and cardenolide production in D. purpurea. Firstly, we report biomass production using a temporary immersion system (TIS), combined with cardenolide extraction and quantification...
2016: Methods in Molecular Biology
Gunce Sahin Cingoz, Ekrem Gurel
Long periods of high temperature or transitory increased temperature, a widespread agricultural problem, may lead to a drastic reduction in economic yield, affecting plant growth and development in many areas of the world. Heat stress causes many anatomical and physiological changes in plants. Its unfavorable effects can be alleviated by thermotolerance induced by exogenous application of plant growth regulators and osmoprotectants or by gradual application of temperature stress. Digitalis trojana Ivanina is an important medicinal plant species well known mainly for its cardenolides...
August 2016: Plant Physiology and Biochemistry: PPB
Fabrizio Oliva, Enrico Ammirati, Carlo Campana, Valentina Carubelli, Antonio Cirò, Giuseppe Di Tano, Andrea Mortara, Michele Senni, Fabrizio Morandi, Marco Metra
Heart rate (HR) is not only a physical sign but also a biomarker. High HR in several cardiac disorders is associated with increased mortality. In heart failure (HF), HR represents an important therapeutic target, both in the acute and chronic phase. Beta-blockers are a milestone of recommended treatments in HF patients with reduced ejection fraction. However, hemodynamic profile or intolerance may limit the use or the optimization of beta-blocker treatment, both during hospitalization and outpatient follow-up...
March 2016: Giornale Italiano di Cardiologia
Dimitrios M Konstantinou, Haralambos Karvounis, George Giannakoulas
Digoxin is one of the oldest compounds used in cardiovascular medicine. Nevertheless, its mechanism of action and most importantly its clinical utility have been the subject of an endless dispute. Positive inotropic and neurohormonal modulation properties are attributed to digoxin, and it was the mainstay of heart failure therapeutics for decades. However, since the institution of β-blockers and aldosterone antagonists as part of modern heart failure medical therapy, digoxin prescription rates have been in free fall...
2016: Cardiology
Carmelo Buttà, Antonino Tuttolomondo, Alessandra Casuccio, Rossella Petrantoni, Giuseppe Miceli, Francesco Cuttitta, Antonio Pinto
Little is known about the role of HRV in atrial fibrillation (AF) patients. Aim of our study was to assess the relationship between HRV measurements and demographic and clinical variables in a population of 274 AF patients. We selected all consecutive patients with persistent/permanent AF among whom had performed a Holter ECG in our Department from April 2010 to April 2015. Time-domain analysis of HRV was evaluated. Demographic and clinical variables were collected for each patient. At multivariable logistic regression, a higher pNN50 was associated with ACE inhibitors/ARBs (p = 0...
March 3, 2016: Heart and Vessels
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