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physiology of heart failure

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https://www.readbyqxmd.com/read/28091823/skeletal-muscle-inflammation-and-atrophy-in-heart-failure
#1
Kory J Lavine, Oscar L Sierra
Heart failure represents a systemic disease with profound effects on multiple peripheral tissues including skeletal muscle. Within the context of heart failure, perturbations in skeletal muscle physiology, structure, and function strongly contribute to exercise intolerance and the morbidity of this devastating disease. There is growing evidence that chronic heart failure imparts specific pathological changes within skeletal muscle beds resulting in muscle dysfunction and tissue atrophy. Mechanistically, systemic and local inflammatory responses drive critical aspects of this pathology...
January 14, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28089685/evaluation-of-drug-drug-interaction-potential-between-sacubitril-valsartan-lcz696-and-statins-using-a-physiologically-based-pharmacokinetic-model
#2
Wen Lin, Tao Ji, Heidi Einolf, Surya Ayalasomayajula, Tsu-Han Lin, Imad Hanna, Tycho Heimbach, Christopher Breen, Venkateswar Jarugula, Handan He
Sacubitril/valsartan (LCZ696) has been approved for the treatment of heart failure. Sacubitril is an in vitro inhibitor of OATPs. In clinical studies, LCZ696 increased atorvastatin Cmax by 1.7-fold and AUC by 1.3-fold, but had little or no effect on simvastatin or simvastatin acid exposure. A PBPK modelling approach was applied to explore the underlying mechanisms behind the statin-specific LCZ696 drug interaction observations. The model incorporated OATP-mediated clearance (CLint,T) for simvastatin and simvastatin acid to successfully describe the PK profiles of either analyte in the absence or presence of LCZ696...
January 12, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28086779/the-effect-of-electrical-conductivity-of-myocardium-on-cardiac-pumping-efficacy-a-computational-study
#3
Ana Rahma Yuniarti, Ki Moo Lim
BACKGROUND AND AIMS: The existence of non-excitable cells in the myocardium leads to the increasing conduction non-uniformity and decreasing myocardial electrical conductivity. Slowed myocardial conduction velocity (MCV) believed to enhance the probability of cardiac arryhthmia and alter the cardiac mechanical pumping efficacy, even in sinus rhythm. Though several studies on the correlation between MCV and cardiac electrical instabilities exist, there has been no study concerning correlation or causality between MCV and cardiac mechanical pumping efficacy, due to the limitation in clinical methods to document and evaluate cardiac mechanical responses directly...
January 10, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28074820/airway-management-of-the-cardiac-surgical-patients-current-perspective
#4
REVIEW
Arindam Choudhury, Nishkarsh Gupta, Rohan Magoon, Poonam Malhotra Kapoor
The difficult airway (DA) is a common problem encountered in patients undergoing cardiac surgery. However, the challenge is not only just establishment of airway but also maintaining a definitive airway for the safe conduct of cardiopulmonary bypass from initiation to weaning after surgical correction or palliation, de-airing of cardiac chambers. This review describes the management of the DA in a cardiac theater environment. The primary aims are recognition of DA both anatomical and physiological, necessary preparations for (and management of) difficult intubation and extubation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073429/relation-of-the-myocardial-contraction-fraction-as-calculated-from-m-mode-echocardiography-with-incident-heart-failure-atherosclerotic-cardiovascular-disease-and-mortality-results-from-the-cardiovascular-health-study
#5
Mathew S Maurer, William J H Koh, Traci M Bartz, Sirish Vullaganti, Eddy Barasch, Julius M Gardin, John S Gottdiener, Bruce M Psaty, Jorge R Kizer
We evaluated the association between 2-dimensional (2D) echocardiography (echo)-determined myocardial contraction fraction (MCF) and adverse cardiovascular outcomes including incident heart failure (HF), atherosclerotic cardiovascular disease (ASCVD), and mortality. The MCF, the ratio of left ventricular (LV) stroke volume (SV) to myocardial volume (MV), is a volumetric measure of myocardial shortening that can distinguish pathologic from physiological hypertrophy. Using 2D echo-guided M-mode data from the Cardiovascular Health Study, we calculated MCF in subjects with LV ejection fraction (EF) ≥55% and used Cox models to evaluate its association with incident HF, ASCVD, and all-cause mortality after adjusting for clinical and echo parameters...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28069473/high-intensity-training-improves-global-and-segmental-strains-in-severe-congestive-heart-failure
#6
Yair Blumberg, Offir Ertracht, Itai Gershon, Noa Bachner-Hinenzon, Tali Reuveni, Shaul Atar
BACKGROUND: High intensity training (HIT) is superior to moderate aerobic training (MAT) for improving quality of life in congestive heart failure (CHF) patients. Speckle tracking echocardiography (STE) has recently been suggested for estimation of left ventricle global and regional function. AIMS: We evaluated the utility of STE for characterizing differences in cardiac function following MAT or HIT in a CHF rat model. METHODS AND RESULTS: Following baseline physiological assessment, CHF was induced by coronary artery ligation in Sprague-Dawley rats...
January 6, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28065846/the-association-of-heart-failure-related-micrornas-with-neurohormonal-signaling
#7
Yei-Tsung Chen, Juan Wang, Kai Sing Tong, Lee Lee Wong, Oi Wah Liew, Arthur Mark Richards
Heart failure (HF) is a widely prevalent syndrome imposing a significant burden of morbidity and mortality world-wide. Differential circulating microRNA profiles observed in HF cohorts suggest the diagnostic utility of microRNAs as biomarkers. Given their function in fine tuning gene expression, alternations in microRNA landscape could reflecting the underlying mechanisms of disease and present potential therapeutic targets. Using multiple computational target predicting algorithms together with the luciferase-based reporting platform, the interactions between HF-related microRNAs and the 3' untranslated regions (3'UTRs) of neurohormone associated genes were examined and compared...
January 5, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28065668/ablation-of-the-cardiac-ryanodine-receptor-phospho-site-ser2808-does-not-alter-the-adrenergic-response-or-the-progression-to-heart-failure-in-mice-elimination-of-the-genetic-background-as-critical-variable
#8
Francisco J Alvarado, Xi Chen, Héctor H Valdivia
BACKGROUND: Phosphorylation of the cardiac ryanodine receptor (RyR2) phospho-site S2808 has been touted by the Marks group as a hallmark of heart failure (HF) and a critical mediator of the physiological fight-or-flight response of the heart. In support of this hypothesis, mice unable to undergo phosphorylation at RyR2-S2808 (S2808A) were significantly protected against HF and displayed a blunted response to adrenergic stimulation. However, the issue remains highly controversial because several groups have been unable to reproduce these findings...
January 6, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28065446/mechanical-dyssynchrony-in-heart-failure-still-a-valid-concept-for-optimizing-treatment
#9
REVIEW
Elena Galli, Christophe Leclercq, Erwan Donal
Cardiac resynchronization therapy (CRT) has had a major favourable impact on the care of patients with symptomatic heart failure, left ventricular ejection fraction<35% and enlarged QRS. Despite this, about 35% of patients who undergo CRT in accordance with current guidelines are "non-responders". Therefore, more accurate selection of CRT candidates would significantly improve patient benefit and decrease costs. In the past decade, some small non-randomized studies have shown that estimation of left ventricular dyssynchrony by echocardiography might be useful to ameliorate the selection of patients for CRT...
January 3, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28062629/unraveling-the-molecular-complexity-of-o-glycosylated-endogenous-n-terminal-pro-b-type-natriuretic-peptide-forms-in-blood-plasma-of-patients-with-severe-heart-failure
#10
Bernhard Halfinger, Angelika Hammerer-Lercher, Benno Amplatz, Bettina Sarg, Leopold Kremser, Herbert H Lindner
BACKGROUND: Currently, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and its physiologically active counterpart, BNP, are most frequently used as biomarkers for diagnosis, prognosis, and disease monitoring of heart failure (HF). Commercial NT-proBNP and BNP immunoassays cross-react to varying degrees with unprocessed proBNP, which is also found in the circulation. ProBNP processing and immunoassay response are related to O-linked glycosylation of NT-proBNP and proBNP. There is a clear and urgent need to identify the glycosylation sites in the endogenously circulating peptides requested by the community to gain further insights into the different naturally occurring forms...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062619/beyond-natriuretic-peptides-for-diagnosis-and-management-of-heart-failure
#11
REVIEW
Nasrien E Ibrahim, James L Januzzi
BACKGROUND: Heart failure (HF) is a complex syndrome with an enormous societal burden in terms of cost and morbidity and mortality. Natriuretic peptide (NP) testing is now widely used to support diagnosis, prognostication, and management of patients with HF, but NPs come with limitations, including vulnerability to the presence of obesity, atrial fibrillation, and renal dysfunction, for example. Beyond the NPs, novel biomarkers may supplement traditional clinical and laboratory testing to improve understanding of the complex disease process of HF, and possibly to personalize care for those affected through better individual phenotyping...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28057794/purinergic-signaling-in-the-cardiovascular-system
#12
REVIEW
Geoffrey Burnstock
There is nervous control of the heart by ATP as a cotransmitter in sympathetic, parasympathetic, and sensory-motor nerves, as well as in intracardiac neurons. Centers in the brain control heart activities and vagal cardiovascular reflexes involve purines. Adenine nucleotides and nucleosides act on purinoceptors on cardiomyocytes, AV and SA nodes, cardiac fibroblasts, and coronary blood vessels. Vascular tone is controlled by a dual mechanism. ATP, released from perivascular sympathetic nerves, causes vasoconstriction largely via P2X1 receptors...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28052915/intracoronary-cardiac-progenitor-cells-in-single-ventricle-physiology-the-perseus-randomized-phase-2-trial
#13
Shuta Ishigami, Shinichi Ohtsuki, Takahiro Eitoku, Daiki Ousaka, Maiko Kondo, Yoshihiko Kurita, Kenta Hirai, Yosuke Fukushima, Kenji Baba, Takuya Goto, Naohiro Horio, Junko Kobayashi, Yosuke Kuroko, Yasuhiro Kotani, Sadahiko Arai, Tatsuo Iwasaki, Shuhei Sato, Shingo Kasahara, Shunji Sano, Hidemasa Oh
RATIONALE: Patients with single ventricle physiology are at high risk of mortality resulting from ventricular dysfunction. The preliminary results of the phase 1 trial showed cardiosphere-derived cells (CDCs) may be effective against congenital heart failure. OBJECTIVE: To determine if intracoronary delivery of autologous CDCs improves cardiac function in patients with single ventricle physiology. METHODS AND RESULTS: We conducted a phase 2 randomized controlled study to assign 41 patients in a 1:1 ratio who had single ventricle physiology undergoing staged-2 or -3 palliation to receive intracoronary infusion of CDCs 4 to 9 weeks after surgery or staged reconstruction alone (study A)...
January 4, 2017: Circulation Research
https://www.readbyqxmd.com/read/28049018/transactivation-of-the-epidermal-growth-factor-receptor-in-responses-to-myocardial-stress-and-cardioprotection
#14
REVIEW
Melissa E Reichelt, Shannon O'Brien, Walter G Thomas, John P Headrick
The epidermal growth factor receptor (EGFR) family comprises the ErbB1 (EGFR) and ErbB4 receptors as well as the 'co-receptors' ErbB2 (which does not bind EGF ligands) and ErbB3 (which lack tyrosine kinase activity). This family of receptors is essential for cardiac development, myocardial, renal and vascular function, and cardiac responses to physiological and pathological perturbations. The EGFR appears critical in protecting cardiac cells from injury, while considerable attention has focussed on neuregulin/ErbB4 signalling in potentially ameliorating cardiomyopathy/heart failure...
December 31, 2016: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/28041584/hemodynamics-of-his-bundle-pacing
#15
REVIEW
Luca Alberti, Paolo Pieragnoli, Giuseppe Ricciardi, Luigi Padeletti
This review will focus on the feasibility of long term His bundle pacing and its effects on left ventricle (LV) hemodynamics. Compared with right ventricular pacing, His bundle pacing results in a more physiological electro-mechanical activation that contributes to preserve LV function. Moreover some studies showed a similar effect to biventricular pacing in patients with heart failure and left bundle branch block. Recent observations indicate that His bundle pacing should be considered as an optimal site to pace right ventricle in patients who are candidates for cardiac resynchronization therapy...
January 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28035527/new-and-emerging-therapies-and-targets-beta-3-agonists
#16
Lauriane Y M Michel, Jean-Luc Balligand
While crucial for the acute physiologic response to stress, the adrenergic system may become maladaptive upon prolonged stimulation in the course of development of heart failure. This has been the basis for the development of beta-blocking therapies, targeting mainly beta1-2 adrenoreceptors (B1-2AR). The third isotype, B3AR, was more recently identified in cardiac myocytes and endothelial cells from human (and many other animal species), where its distinctive coupling to nitric oxide and antioxidant pathways suggested potential protective properties that were unexploited so far...
December 30, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28034657/failure-of-physiologic-transformation-of-spiral-arteries-endothelial-and-trophoblast-cell-activation-and-acute-atherosis-in-the-basal-plate-of-the-placenta
#17
Carlos A Labarrere, Hector L Dicarlo, Elaine Bammerlin, James W Hardin, Yeon M Kim, Piya Chaemsaithong, David M Haas, Ghassan S Kassab, Roberto Romero
BACKGROUND: Failure of physiologic transformation of spiral arteries has been reported in preeclampsia, fetal growth restriction, fetal death, and spontaneous preterm labor with intact or ruptured membranes. Spiral arteries with failure of physiologic transformation are prone to develop atherosclerotic-like lesions of atherosis. There are striking parallels between preeclampsia and atherosclerotic disease, and between lesions of atherosis and atherosclerosis. Endothelial activation, identified by intercellular adhesion molecule-1 (ICAM-1) expression, is present in atherosclerotic-like lesions of heart transplantation, and is considered a manifestation of rejection...
December 26, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28032941/permanent-his-bundle-pacing-the-past-present-and-future
#18
REVIEW
Parikshit S Sharma, Kenneth A Ellenbogen, Richard G Trohman
Long-term right ventricular (RV) apical pacing has been associated with an increased risk of death, heart failure (HF) and atrial fibrillation (AF). Alternative sites for RV pacing have not proven to be superior to right ventricular apical pacing. Cardiac resynchronization therapy (CRT) using a biventricular (BiV) lead system is indicated for patients with a low left ventricular ejection fractions (LVEF) and QRS prolongation, but there remains about a 25-30% non-response rate. CRT has been less effective for non-LBBB conduction delay and with normal/low normal left ventricular (LV) function...
December 29, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28029021/bile-acid-nuclear-receptor-farnesoid-x-receptor-therapeutic-target-for-nonalcoholic-fatty-liver-disease
#19
REVIEW
Sun Gi Kim, Byung Kwon Kim, Kyumin Kim, Sungsoon Fang
Nonalcoholic fatty liver disease (NAFLD) is one of the causes of fatty liver, occurring when fat is accumulated in the liver without alcohol consumption. NAFLD is the most common liver disorder in advanced countries. NAFLD is a spectrum of pathology involving hepatic steatosis with/without inflammation and nonalcoholic steatohepatitis with accumulation of hepatocyte damage and hepatic fibrosis. Recent studies have revealed that NAFLD results in the progression of cryptogenic cirrhosis that leads to hepatocarcinoma and cardiovascular diseases such as heart failure...
December 2016: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28011835/comparing-maximum-rate-and-sustainability-of-pacing-by-mechanical-vs-electrical-stimulation-in-the-langendorff-perfused-rabbit-heart
#20
T Alexander Quinn, Peter Kohl
AIMS: Mechanical stimulation (MS) represents a readily available, non-invasive means of pacing the asystolic or bradycardic heart in patients, but benefits of MS at higher heart rates are unclear. Our aim was to assess the maximum rate and sustainability of excitation by MS vs. electrical stimulation (ES) in the isolated heart under normal physiological conditions. METHODS AND RESULTS: Trains of local MS or ES at rates exceeding intrinsic sinus rhythm (overdrive pacing; lowest pacing rates 2...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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