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physiology of heart failure

Oscar H L Bing
Ammonia plays a central role in the life and death of all living organisms and has been studied for over one hundred years. Ammonia is necessary for growth and development but it is toxic in excess and, as a result, differing methods of ammonia neutralization have evolved. Following physiological and pathological stress to the heart, tissue ammonia levels rise. Local ammonia neutralization may be inadequate and excess ammonia may exert its toxic effects. Phenylbutyrate (PBA), which is FDA approved for the treatment of elevated blood ammonia in urea cycle disorders, provides an accessory pathway for ammonia clearance...
March 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Kasper Meidahl Petersen, Søren Bøgevig, Jens Juul Holst, Filip Krag Knop, Mikkel Bring Christensen
Context: Glucagon's effects on hemodynamic parameters - most notably heart rate and cardiac contractility - are overlooked. The glucagon receptor is a central target in novel and anticipated type 2 diabetes therapies and hemodynamic consequences of glucagon signaling have therefore become increasingly important. In this review we summarize and evaluate published studies on glucagon pharmacology with focus on clinical hemodynamic effects in humans. Evidence acquisition: PubMed, EMBASE and the Cochrane library were searched for clinical studies concerning hemodynamic effects of glucagon (no year restriction)...
March 13, 2018: Journal of Clinical Endocrinology and Metabolism
Julio Sandoval
Despite advances in drug therapy, pulmonary hypertension-particularly arterial hypertension (PAH)-remains a fatal disease. Untreatable right heart failure (RHF) from PAH eventually ensues and remains a significant cause of death in these patients. Lowering pulmonary input impedance with different PAH-specific drugs is the obvious therapeutic target in RHF due to chronically increased afterload. However, potential clinical gain can also be expected from attempts to unload the right heart and increase systemic output...
March 12, 2018: Revista Española de Cardiología
S Arques
Cardiovascular diseases are the leading cause of death worldwide. Conceptually, endothelial dysfunction, inflammatory status and oxidative stress are at the forefront in the onset and development of most cardiovascular diseases, particularly coronary artery disease and heart failure. Serum albumin, the most abundant plasma protein, has many physiological properties, including anti-inflammatory, antioxidant and antiplatelet aggregation activity. It also plays an essential role in the fluid exchange across the capillary membrane...
March 12, 2018: Annales de Cardiologie et D'angéiologie
Mohamed Abdelrahman, Faiz A Subzposh, Dominik Beer, Brendan Durr, Angela Naperkowski, Haiyan Sun, Jess W Oren, Gopi Dandamudi, Pugazhendhi Vijayaraman
BACKGROUND: Right ventricular pacing (RVP) is associated with heart failure and increased mortality. His bundle pacing (HBP) is a physiological alternative to RVP. OBJECTIVE: The aim of the study is to evaluate clinical outcomes of HBP compared to RVP. METHODS: All patients requiring initial pacemaker implantation between Oct 1st , 2013 and December 31st , 2016 were included in the study. Permanent HBP was attempted in consecutive patients at one hospital and RVP at a sister hospital...
March 5, 2018: Journal of the American College of Cardiology
Nabeel Quryshi, Laura E Norwood Toro, Karima Ait-Aissa, Amanda Kong, Andreas M Beyer
Although chemotherapeutics can be highly effective at targeting malignancies, their ability to trigger cardiovascular morbidity is clinically significant. Chemotherapy can adversely affect cardiovascular physiology, resulting in the development of cardiomyopathy, heart failure and microvascular defects. Specifically, anthracyclines are known to cause an excessive buildup of free radical species and mitochondrial DNA damage (mt DNA) that can lead to oxidative stress-induced cardiovascular apoptosis. Therefore, oncologists and cardiologists maintain a network of communication when dealing with patients during treatment in order to treat and prevent chemotherapy-induced cardiovascular damage; however, there is a need to discover more accurate biomarkers and therapeutics to combat and predict the onset of cardiovascular side effects...
March 10, 2018: International Journal of Molecular Sciences
Bence Hegyi, Julie Bossuyt, Leigh G Griffiths, Rafael Shimkunas, Zana Coulibaly, Zhong Jian, Kristin N Grimsrud, Claus S Sondergaard, Kenneth S Ginsburg, Nipavan Chiamvimonvat, Luiz Belardinelli, András Varró, Julius G Papp, Piero Pollesello, Jouko Levijoki, Leighton T Izu, W Douglas Boyd, Tamás Bányász, Donald M Bers, Ye Chen-Izu
Heart failure (HF) following myocardial infarction (MI) is associated with high incidence of cardiac arrhythmias. Development of therapeutic strategy requires detailed understanding of electrophysiological remodeling. However, changes of ionic currents in ischemic HF remain incompletely understood, especially in translational large-animal models. Here, we systematically measure the major ionic currents in ventricular myocytes from the infarct border and remote zones in a porcine model of post-MI HF. We recorded eight ionic currents during the cell's action potential (AP) under physiologically relevant conditions usingself AP-clamp sequential dissection...
March 12, 2018: Proceedings of the National Academy of Sciences of the United States of America
Élie Besserer-Offroy, Patrick Bérubé, Jérôme Côté, Alexandre Murza, Jean-Michel Longpré, Robert Dumaine, Olivier Lesur, Mannix Auger-Messier, Richard Leduc, Éric Marsault, Philippe Sarret
The apelinergic system is an important player in the regulation of both vascular tone and cardiovascular function, making this physiological system an attractive target for drug development for hypertension, heart failure and ischemic heart disease. Indeed, apelin exerts a positive inotropic effect in humans whilst reducing peripheral vascular resistance. In this study, we investigated the signaling pathways through which apelin exerts its hypotensive action. We synthesized a series of apelin-13 analogs whereby the C-terminal Phe13 residue was replaced by natural or unnatural amino acids...
March 9, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
I Cundrle, P Suk, V Sramek, Z Lacinova, M Haluzik
Physiologically, leptin concentration is controlled by circadian rhythm. However, in critically ill patients, circadian rhythm is disrupted. Thus we hypothesized that circadian leptin concentration changes are not preserved in critically ill patients. Ten consecutive critically ill heart failure patients with the clinical indication for mechanical ventilation and sedation were included into our study. Plasma leptin concentration was measured every 4 h during the first day (0-24 h) and during the third day (48-72 h) after admission...
March 12, 2018: Physiological Research
Alexandre Lewalle, Sander Land, Eric Carruth, Lawrence R Frank, Pablo Lamata, Jeffrey H Omens, Andrew D McCulloch, Steven A Niederer, Nicolas P Smith
The cardiac system compensates for variations in physiological and pathophysiological conditions through a dynamic remodeling at the organ, tissue, and intracellular levels in order to maintain function. However, on longer time scales following the onset of ventricular pressure overload, such remodeling may begin to inhibit physiological function and ultimately lead to heart failure. This progression from compensatory to decompensatory behavior is poorly understood, in particular owing to the absence of a unified perspective of the concomitantly remodeling subsystems...
2018: Frontiers in Physiology
Koh Ono, Yasuhide Kuwabara, Takahiro Horie, Takeshi Kimura
Protein-coding genes account for less than 2% of the whole genome. However, the advances in RNA sequencing and genome-wide analysis have demonstrated that most of the genome is capable of being transcribed. Moreover, recent studies have suggested that long non-coding RNAs (lncRNAs) are critical regulators of gene expression and epigenesis in both physiological and disease states. Several lncRNAs are functionally involved in cardiovascular diseases and may be potential therapeutic targets. Here, we review the current strategies for the discovery of functional lncRNAs and recently discovered lncRNAs in the cardiovascular field, focusing on cardiac development, hypertrophy, heart failure, and atherosclerosis...
March 10, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Yasuhiro Maejima
Autophagy is an evolutionarily conserved process for degradation of long-lived proteins and organelles that govern a number of cardiac pathologies which cause heart failure. Indeed, recent investigations have uncovered pathways that regulate autophagy in the heart and underlying mechanisms by which alterations in this process affect cardiac function and structure. One of the major roles of autophagy in cardiomyocytes is the intracellular protein quality control (PQC). Impairment of autophagy causes aggregation of damaged and/or misfolded proteins in cardiomyocytes, thereby damaging the cells which, in turn leads to pathological cardiac remodeling...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
Timothy D Bryson, Xiaosong Gu, Remonda M Khalil, Safa Khan, Liping Zhu, Jiang Xu, Edward Peterson, Xiao-Ping Yang, Pamela Harding
BACKGROUND: Prostaglandin E2 (PGE2 ) signals through 4 separate G-protein coupled receptor sub-types to elicit a variety of physiologic and pathophysiological effects. We recently reported that PGE2 via its EP3 receptor could reduce cardiac contractility of isolated myocytes and the working heart preparation. We thus hypothesized that there is an imbalance in the EP3/EP4 ratio towards EP3 in the failing heart and that overexpression of EP4 in a mouse model of heart failure would improve cardiac function...
March 6, 2018: Journal of Molecular and Cellular Cardiology
Maja Elstad, Erin L O'Callaghan, Alexander J Smith, A Ben-Tal, Rohit Ramchandra
The cardiorespiratory system exhibits oscillations from a range of sources. One of the most studied oscillations is heart rate variability, which is thought to be beneficial and can serve as an index of a healthy cardiovascular system. Heart rate variability is dampened in many diseases including depression, autoimmune diseases, hypertension and heart failure. Thus, understanding the interactions that lead to heart rate variability, and its physiological role, could help with prevention, diagnosis and treatment of cardiovascular diseases...
March 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
William A Huang, Maereg A Wassie, Olujimi A Ajijola
His bundle pacing (HBP) has been shown to be a feasible, beneficial, and safe way to achieve cardiac resynchronization therapy (CRT) with recruitment of the heart's physiological conduction system. HBP should be considered for those with unfavorable coronary sinus (CS) anatomy, and nonresponders to biventricular (BiV) pacing. HBP CRT may also help patients with the nonleft bundle branch block form of conduction delay and heart failure (HF). HBP CRT should be considered strongly in preventing right ventricular (RV) pacing-induced cardiomyopathy, especially after atrioventricular nodal ablation given the discrete nature of the block and the low likelihood of distal block...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Zhi-Gang Zhang, Xin-Min Liu
RATIONALE: Tolvaptan (TLV) is a new vasopressin type 2 receptor antagonist effective in patients with heart failure (HF). Accumulating evidences have revealed that treatment with TLV does not alter the blood pressure significantly. PATIENT CONCERNS: An 84-year-old man was diagnosed with acute exacerbation of chronic HF due to ischemic cardiomyopathy, arrhythmia, mitral and aortic regurgitation. Treatment with TLV increased the urine volume and improved the dyspnea...
January 2018: Medicine (Baltimore)
P Burgueño, C González, A Sarralde, F Gordo
Extracorporeal membrane oxygenation (ECMO) support is indicated in patients who are refractory to treatment, those with cardiogenic shock or respiratory failure and those with exacerbations eligible for heart and lung transplantation. Physician experience and quantity of necessary resources are reasons why regionalization could benefit patients of this kind, establishing ECMO reference centers and integrating a transportation network specialized in ECMO. This type of transportation is a challenge for healthcare systems and physicians, given its greater complexity, requiring a multidisciplinary and inter-territorial approach...
March 1, 2018: Medicina Intensiva
Akiomi Yoshihisa, Satoshi Abe, Takatoyo Kiko, Yusuke Kimishima, Yu Sato, Shunsuke Watanabe, Yuki Kanno, Makiko Miyata-Tatsumi, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Takafumi Ishida, Yasuchika Takeishi
BACKGROUND: Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF). METHODS AND RESULTS: We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into three groups based on serum zinc levels (µg/dl): 1st (zinc≥75, n=323), 2nd (62≤zinc<75, n=322) and 3rd (zinc<62, n=323) tertiles...
March 1, 2018: Journal of Cardiac Failure
Shana R Watson, James D Dormer, Baowei Fei
There has been an increasing interest in studying cardiac fibers in order to improve the current knowledge regarding the mechanical and physiological properties of the heart during heart failure (HF), particularly early HF. Having a thorough understanding of the changes in cardiac fiber orientation may provide new insight into the mechanisms behind the progression of left ventricular (LV) remodeling and HF. We conducted a systematic review on various technologies for imaging cardiac fibers and its link to HF...
March 2, 2018: Heart Failure Reviews
Miha Mlakar, Paolo Emilio Puddu, Maja Somrak, Silvio Bonfiglio, Mitja Luštrek
This paper addresses patient-reported outcomes (PROs) and telemonitoring in congestive heart failure (CHF), both increasingly important topics. The interest in CHF trials is shifting from hard end-points such as hospitalization and mortality, to softer end-points such health-related quality of life. However, the relation of these softer end-points to objective parameters is not well studied. Telemonitoring is suitable for collecting both patient-reported outcomes and objective parameters. Most telemonitoring studies, however, do not take full advantage of the available sensor technology and intelligent data analysis...
2018: PloS One
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