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stress hormones in cardiac surgery

Ioanna Iliopoulou, Iordanis Mourouzis, George I Lambrou, Dimitra Iliopoulou, Dimitrios-Dionysios Koutsouris, Constantinos Pantos
Cardiac function is reduced following myocardial infarction (MI) due to myocardial injury and alterations in the viable non‑ischemic myocardium, a process known as cardiac remodeling. The current treatments available for patients with acute MI (AMI) reduce infarct size, preserve left ventricular (LV) function and improve survival; however, these treatments do not prevent remodeling, which can lead to heart failure. The aim of the present study was to investigate the effects of thyroid hormone (TH) treatment following MI in an in vivo rat model...
May 11, 2018: Molecular Medicine Reports
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Feng-Han Chiu, Chih-Jen Yang, Chih-Kang Huang, Chih-Yuan Lin, Shih-Hung Tsai
Acute cardiopulmonary distress in pregnancy always carries exceptionally arduous challenge for physicians. Here we report a patient who sustained spontaneous chordae tendineae rupture complicated with severe mitral regurgitation and acute pulmonary edema during peripartum period. Probable causes of chordae tendineae rupture include mitral valve prolapse, infectious endocarditis, congenital heart disease, rheumatic heart disease, ischemic heart disease, connective tissue diseases, previous mitral valve surgery or pregnancy itself...
March 19, 2018: American Journal of Emergency Medicine
Rayane Brinck Teixeira, Alexsandra Zimmer, Alexandre Luz de Castro, Cristina Campos Carraro, Karina Rabello Casali, Ingrid Gonçalves Machuca Dias, Alessandra Eifler Guerra Godoy, Isnard Elman Litvin, Adriane Belló-Klein, Alex Sander da Rosa Araujo
AIMS: This study aimed to investigate whether beneficial effects of thyroid hormones are comparable to those provided by the aerobic exercise training, to verify its applicability as a therapeutic alternative to reverse the pathological cardiac remodeling post-infarction. MATERIALS AND METHODS: Male rats were divided into SHAM-operated (SHAM), myocardial infarction (MI), MI subjected to exercise training (MIE), and MI who received T3 and T4 treatment (MIH) (n = 8/group)...
March 1, 2018: Life Sciences
Antonio Aversa, Andrea Fabbri
The relationship between testosterone deficiency (TD) syndrome and surgical resilience has a great impact in the modern approach to male elderly patients. There is good evidence that low levels of T are a strong marker for cardiovascular risk; also, TD is frequently associated with increased cardiovascular and all-cause mortality especially in cardiac older frail men. Screening for low T should be mandatory in high risk groups candidate to surgery including those with diabetes, metabolic syndrome and obesity, even though benefits from T-treatment on survival rates are unclear...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Konstantin A Krychtiuk, Maria C Honeder, Max Lenz, Gerald Maurer, Johann Wojta, Gottfried Heinz, Kurt Huber, Walter S Speidl
BACKGROUND: Critically ill patients admitted to a medical intensive care unit exhibit a high mortality rate irrespective of the cause of admission. Besides its role in fluid and electrolyte balance, vasopressin has been described as a stress hormone. Copeptin, the C-terminal portion of provasopressin mirrors vasopressin levels and has been described as a reliable biomarker for the individual's stress level and was associated with outcome in various disease entities. The aim of this study was to analyze whether circulating levels of copeptin at ICU admission are associated with 30-day mortality...
2017: PloS One
M C El Hajj, V K Ninh, E C El Hajj, J M Bradley, J D Gardner
We have previously demonstrated the cardioprotective effects of ovarian hormones against adverse ventricular remodeling imposed by chronic volume overload. Here, we assess the estrogen receptor dependence of this cardioprotection. Four groups of female rats were studied: sham-operated (Sham), volume overloaded [aortocaval fistula (ACF)], Sham treated with estrogen receptor antagonist ICI 182,780 (Sham + ICI), and ACF treated with ICI. Cardiac function was assessed temporally using echocardiogram, and tissue samples were collected at 5 days and 6 wk postsurgery...
January 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
S Pozzoli, M Simonini, E Messaggio, N Casamassima, E Bignami, L Zagato, C Lanzani, P Manunta
OBJECTIVE: Cardiovascular diseases remain the main cause of mortality and morbidity worldwide. The identification of subjects with increased risk of developing new cardiovascular events remains a priority in order to guide treatments and determine individual prognosis. Biomarkers are useful tools that are able to help physicians in decision-making. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure...
September 2016: Journal of Hypertension
Yan Li, Qing Yuan, Jie Huang, Yi Ping Li, Jian Pan, Xing Feng, Xue Guang Zhang, Jiang Huai Wang, Jian Wang
BACKGROUND: Surgical stress initiates a series of host hormone, metabolism and immune responses, which predominantly affect the homeostatic mechanism of patients with major surgery. B7-H3 is a co-stimulatory molecule and has been shown to participate in both adaptive and innate immune responses. In this study we evaluated the clinical significance of plasma B7-H3 levels in pediatric patients with different types of operation and degrees of surgical stress. METHODS: A total of 48 children received pediatric general and cardiac surgery were recruited into this study...
July 26, 2016: BMC Pediatrics
Özge Korkmaz, Hakki Kaya, Osman Beton, Ali Zorlu, Sabahattin Göksel, Müslim Gül, İlker İnce, Öcal Berkan, Mehmet Birhan Yılmaz
OBJECTIVE: Coronary artery bypass graft surgery in one of the most effective and widely used methods employed in the treatment of ischemic heart disease, but many factors to various degrees are directly associated with perioperative and postoperative problems. In this study, we evaluated the relationship between preoperative eosinophil count and postoperative mortality in patients who underwent coronary artery bypass graft operation. METHODS: A total of 241 patients (157 males, 84 females) who underwent isolated on-pump coronary artery bypass graft operation between 2011 and 2013 in two centers were evaluated retrospectively...
April 18, 2016: Heart Surgery Forum
Hongbin Sun, Liping Zhang, Xiuli Han, Zhongyu Wang, Lei Xu
OBJECTIVE: To compare the effects of thoracotomy and total thoracoscopic surgery on coronary artery fistulae complicated with ectasia. METHODS: Forty-six patients with coronary artery fistulae complicated with ectasia were randomly divided into a treatment group and a control group (n=23) which were given totally thoracoscopic surgery and thoracotomy respectively. Both groups were followed up. RESULTS: All patients survived the surgeries and were discharged from the hospital...
January 2016: Pakistan Journal of Medical Sciences Quarterly
Elizabeth W Duggan, Matthew A Klopman, Arnold J Berry, Guillermo Umpierrez
Hyperglycemia is a frequent manifestation of critical and surgical illness, resulting from the acute metabolic and hormonal changes associated with the response to injury and stress (Umpierrez and Kitabchi, Curr Opin Endocrinol. 11:75-81, 2004; McCowen et al., Crit Care Clin. 17(1):107-24, 2001). The exact prevalence of hospital hyperglycemia is not known, but observational studies have reported a prevalence of hyperglycemia ranging from 32 to 60 % in community hospitals (Umpierrez et al., J Clin Endocrinol Metab...
March 2016: Current Diabetes Reports
L van Gulik, Sjgm Ahlers, M van Dijk, P Bruins, M E Meima, Y B de Rijke, H S Biemond-Moeniralam, D Tibboel, C A J Knibbe
The gold standard for quantification of pain is a person's self-report. However, we need objective parameters for pain measurement when intensive care patients, for example, are not able to report pain themselves. An increase in pain is currently thought to coincide with an increase in stress hormones. This observational study investigated whether procedure-related pain is associated with an increase of plasma cortisol, adrenaline, and noradrenaline. In 59 patients receiving intensive care after cardiac surgery, cortisol, adrenaline, and noradrenaline plasma levels were measured immediately before and immediately after patients were turned for washing, either combined with the removal of chest tubes or not...
January 2016: Anaesthesia and Intensive Care
Marco Simonini, Simona Pozzoli, Elena Bignami, Nunzia Casamassima, Elisabetta Messaggio, Chiara Lanzani, Elena Frati, Irene Maria Botticelli, Francesco Rotatori, Ottavio Alfieri, Alberto Zangrillo, Paolo Manunta
Cardiovascular diseases remain the main cause of mortality and morbidity worldwide; primary prevention is a priority for physicians. Biomarkers are useful tools able to identify high-risk individuals, guide treatments, and determine prognosis. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure. In a population of 845 patients undergoing elective cardiac surgery, we have investigated the relationships between EO and echocardiography parameters/plasmatic biomarker of cardiac function...
2015: BioMed Research International
Yingying Sun, Hongwu Ye, Yin Xia, Yuanhai Li, Xianren Yuan, Xing Wang
BACKGROUND: This study aims to explore the clinical efficacy of dexmedetomidine (DEX) in the diminution of fentanyl dosage in pediatric cardiac surgery based on some clinical and biochemical parameters. METHODS: Fifty pediatric patients (American Society of Anesthesiologists II), 1-6 years old, were randomly allocated into two groups: group F (control group), in which patients received normal saline and high dosage of fentanyl (30 μg/kg), and group D, in which patients were given DEX and low dosage of fentanyl (15 μg/kg)...
June 2017: Minerva Pediatrica
Judith Hoefer, Eve Pierer, Barbara Rantner, Karl-Heinz Stadlbauer, Gustav Fraedrich, Josef Fritz, Axel Kleinsasser, Corinna Velik-Salchner
OBJECTIVE: Locoregional anesthesia is an effective method for evaluating cerebral function during carotid endarterectomy (CEA). Landmark-guided regional anesthesia (RA) is currently used for CEA and can provoke substantial perioperative hypertension. Ultrasound-guided RA (US-RA) is a new method for performing RA in CEA; however, the effect on sympathetic activity and blood pressure is uncertain. This study assessed early sympathetic activity during CEA in US-RA compared with general anesthesia (GA)...
July 2015: Journal of Vascular Surgery
Aymen N Naguib, Peter D Winch, Joseph D Tobias, Keith O Yeates, Yongjie Miao, Mark Galantowicz, Timothy M Hoffman
INTRODUCTION: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. MATERIALS AND METHODS: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1(st) year of life...
January 2015: Saudi Journal of Anaesthesia
Constantinos Pantos, Iordanis Mourouzis
Thyroid hormone (TH) appears to have a critical role in cardiac repair after injury beyond its role in development and metabolism homeostasis. This unique action is due to the fact that TH effect on the heart is shown to be differentiated depending on its administration on injured or healthy myocardium. Thus, TH can limit ischemia-reperfusion injury via a fine balance between pro-apoptotic and pro-survival signaling pathways. This response is thyroid hormone receptor (TRα1) dependent. Furthermore, an interaction between stress-induced growth kinase signaling and TRα1 is shown to occur and determine postischemic remodeling and cardiac recovery depending on the availability of TH...
May 2015: Heart Failure Reviews
Hirofumi Saiki, Seiko Kuwata, Clara Kurishima, Yoichi Iwamoto, Hirotaka Ishido, Satoshi Masutani, Hideaki Senzaki
Abnormal water metabolism is frequently observed after Fontan surgery. We hypothesized that patients' adrenal hormones show unique responses immediately after Fontan operation and that such a hormonal profile is related to postoperative hemodynamics and water imbalance. Twenty-eight patients who underwent a Fontan operation (n = 16) or a non-Fontan type operation (n = 12; controls) under cardiopulmonary bypass were studied. Postoperative urine cortisol and aldosterone levels were measured daily to minimize the influence of circadian rhythms and temporal hemodynamic variations...
November 15, 2014: American Journal of Cardiology
Jahan Porhomayon, Sergei Kolesnikov, Nader D Nader
The relationship and interactions between stress hormones and post-traumatic stress disorder (PTSD) are well established from both animal and human research studies. This interaction is especially important in the post-operative phase of cardiac surgery where the development of PTSD symptoms will result in increased morbidity and mortality and prolong length of stay for critically ill cardiac surgery patients. Cardiopulmonary bypass itself will independently result in massive inflammation response and release of stress hormones in the perioperative period...
2014: Journal of Cardiovascular and Thoracic Research
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