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inotropics in heart failure

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https://www.readbyqxmd.com/read/29406471/life-threatening-accidental-intravenous-epinephrine-overdose-in-a-12-year-old-boy
#1
Maya Caroline André, Jürg Hammer
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). He reacted with acute loss of consciousness and acute cardiorespiratory failure due to arterial hypotension, ischemic heart failure, and severe pulmonary edema...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29403281/metastatic-leiomyosarcoma-presenting-as-a-lung-mass-with-left-atrial-extension-case-report-and-anesthetic-management
#2
Yinyin Qu, Qing Zheng, Cheng Ni, Zhongqi Cui, Xiangyang Guo
Introduction: Lung metastasis of leiomyosarcoma that protrudes into the left atrium is an extremely rare condition. Severe complications may occur that prominently increase the mortality during the perioperative period. Currently, the anesthetic management reports are limited and there is no generally acknowledged algorithm available. Case presentation: A 67-year-old man presented with cough and dyspnea for 10 days. Workup revealed bilateral pulmonary effusion. Transthoracic echocardiography showed a large mass in the left atrium...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29400260/noteworthy-literature-published-in-2017-for-cardiothoracic-anesthesiologists
#3
Dirk J Varelmann, Jochen Daniel Muehlschlegel
The year 2017 was a year dominated by large-scale clinical studies reporting the outcome of various interventions in cardiac surgery and heart failure (HF) patients, relevant to all cardiothoracic anesthesiologists. Among them were studies investigating the addition of levosimendan, an alternative inotropic agent, to standard management of patients with HF undergoing cardiac surgery. Also, corticosteroids have been used for various purposes in cardiac patients. Here, a new study reports the effect of high-dose methylprednisolone on recovery and delirium...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29395891/hemodynamic-support-of-a-15-year-old-waiting-for-a-heart-transplant-is-there-a-role-for-levosimendan-in-pediatric-heart-failure
#4
I Goyer, D Brossier, B Toledano
Decompensated heart failure in children requires rapid and aggressive support. In refractory cases, invasive supportive care is essential to ensure cardiac output. This results in lengthy pediatric intensive care unit (PICU) stays, secondary morbidity, and high cost. Levosimendan may help palliate the pitfalls encountered with the usual treatment. It has been shown to improve hemodynamics and decrease morbidity and mortality from heart failure in adult trials and pediatric cohorts. We report the case of a 15-year-old boy with dilated cardiomyopathy and refractory ventricular dysfunction who was weaned from continuous inotropes and discharged from the PICU with levosimendan while waiting for heart transplantation...
January 26, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29392537/enhanced-cardiac-s100a1-expression-improves-recovery-from-global-ischemia-reperfusion-injury
#5
S Jungi, X Fu, A Segiser, M Busch, P Most, M Fiedler, T Carrel, H Tevaearai Stahel, S L Longnus, Henriette Most
Gene-targeted therapy with the inotropic Ca2 + -sensor protein S100A1 rescues contractile function in post-ischemic heart failure and is being developed towards clinical trials. Its proven beneficial effect on cardiac metabolism and mitochondrial function suggests a cardioprotective effect of S100A1 in myocardial ischemia-reperfusion injury (IRI). Fivefold cardiomyocyte-specific S100A1 overexpressing, isolated rat hearts perfused in working mode were subjected to 28 min ischemia (37 °C) followed by 60 min reperfusion...
February 1, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29380144/contemporary-perspectives-in-durable-mechanical-circulatory-support-what-did-we-learn-in-the-last-3%C3%A2-years
#6
REVIEW
Jayant Raikhelkar, Nir Uriel
PURPOSE OF REVIEW: In this paper, we will review developments in the field of durable mechanical circulatory support over the past 3 years. RECENT FINDINGS: The role of left ventricular assist device (LVAD) placement in non-inotrope-dependent ambulatory heart failure patients remains controversial in light of recent clinical trials. New devices are on the horizon for destination therapy in advanced heart failure patients. The concept of hemocompatibility and the calculation of hemocompatibility scores represent a novel approach to common adverse events...
January 29, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29376560/inotropic-agents-and-vasodilator-strategies-for-the-treatment-of-cardiogenic-shock-or-low-cardiac-output-syndrome
#7
REVIEW
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29367542/insights-from-second-line-treatments-for-idiopathic-dilated-cardiomyopathy
#8
Marco Luciani, Federica Del Monte
BACKGROUND: Dilated cardiomyopathy (DCM) is an independent nosographic entity characterized by left ventricular dilatation and contractile dysfunction leading to heart failure (HF). The idiopathic form of DCM (iDCM) occurs in the absence of coronaropathy or other known causes of DCM. Despite being different from other forms of HF for demographic, clinical, and prognostic features, its current pharmacological treatment does not significantly diverge. METHODS: In this study we performed a Pubmed library search for placebo-controlled clinical investigations and a post-hoc analysis recruiting iDCM from 1985 to 2016...
August 23, 2017: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29366566/inadequate-preoperative-nutrition-might-be-associated-with-acute-kidney-injury-and-greater-illness-severity-postoperatively
#9
Kurt D Piggott, Anne Liu, Jessica Monczka, Harun Fakioglu, Sukumar Suguna Narasimhulu, Kamal Pourmoghadam, William DeCampli
OBJECTIVE: Nutrition is vital for maintaining optimal cellular and organ function, particularly in neonates who undergo cardiac surgery. Achieving nutritional goals preoperatively can be challenging because of fluid restrictions, suboptimal oral intake, and concerns for inadequate gastrointestinal circulation. We examined preoperative caloric intake and its effects on postoperative course in neonates who underwent cardiac surgery. METHODS: We retrospectively reviewed records of neonates (younger than 30 days) who underwent congenital heart surgery requiring cardiopulmonary bypass from 2008 to 2014 at Arnold Palmer Hospital for Children...
December 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29357490/chronic-low-intensity-exercise-attenuates-cardiomyocyte-contractile-dysfunction-and-impaired-adrenergic-responsiveness-in-aortic-banded-mini-swine
#10
Jessica A Hiemstra, Adam B Veteto, Michelle D Lambert, T Dylan Olver, Brian S Ferguson, Kerry S McDonald, Craig A Emter, Timothy L Domeier
Exercise improves clinical outcomes in patients diagnosed with heart failure with reduced ejection fraction (HFrEF), in part via beneficial effects on cardiomyocyte Ca2+ cycling during excitation-contraction coupling (ECC). However, limited data exist regarding the effects of exercise training on cardiomyocyte function in patients diagnosed with heart failure with preserved ejection fraction (HFpEF). The purpose of this study was to investigate cardiomyocyte Ca2+ handling and contractile function following chronic low-intensity exercise training in aortic-banded miniature swine, and test the hypothesis that low-intensity exercise improves cardiomyocyte function in a large animal model of pressure overload...
January 4, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29344379/changes-in-contractile-protein-expression-are-linked-to-ventricular-stiffness-in-infants-with-pulmonary-hypertension-or-right-ventricular-hypertrophy-due-to-congenital-heart-disease
#11
Andrew R Bond, Dominga Iacobazzi, Safa Abdul-Ghani, Mohammed Ghorbel, Kate Heesom, Mariangela Wilson, Christopher Gillett, Sarah J George, Massimo Caputo, Saadeh Suleiman, Robert M R Tulloh
Background: The right ventricle (RV) is not designed to sustain high pressure leading to failure. There are no current medications to help RV contraction, so further information is required on adaption of the RV to such hypertension. Methods: The Right Ventricle in Children (RVENCH) study assessed infants with congenital heart disease undergoing cardiac surgery with hypertensive RV. Clinical and echocardiographic data were recorded, and samples of RV were taken from matched infants, analysed for proteomics and compared between pathologies and with clinical and echocardiographic outcome data...
2018: Open Heart
https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#12
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29338996/incidence-and-predictors-of-postoperative-need-for-high-dose-inotropic-support-in-patients-undergoing-cardiac-surgery-for-infective-endocarditis
#13
Alessandro Belletti, Stephan Jacobs, Giovanni Affronti, Alexander Mladenow, Giovanni Landoni, Volkmar Falk, Felix Schoenrath
OBJECTIVE: Patients with infective endocarditis undergoing cardiac surgery are a high-risk population. Few data on incidence and predictors of need for high-dose inotropic support in this setting are currently available. DESIGN: Retrospective study. SETTING: Tertiary-care hospital. PARTICIPANTS: Ninety consecutive patients undergoing cardiac surgery for infective endocarditis. INTERVENTIONS: None...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29335384/predictors-of-hemodynamic-improvement-and-stabilization-following-intraaortic-balloon-pump-implantation-in-patients-with-advanced-heart-failure
#14
Teruhiko Imamura, Colleen Juricek, Ann Nguyen, Ben Chung, Daniel Rodgers, Gabriel Sayer, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, David Onsanger, Daniel Burkhoff, Valluvan Jeevanandam, Nir Uriel
OBJECTIVES: The intraaortic balloon pump (IABP) is currently an essential tool to improve hemodynamics in patients with advanced heart failure (HF). This study investigated predictors for hemodynamic improvement or stabilization with IABP therapy in patients with advanced HF. METHODS: Patients with advanced HF and hemodynamic deterioration treated with IABP were enrolled in this retrospective study. Invasive hemodynamics were measured before IABP implantation and 2 weeks after IABP initiation...
January 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29331959/probenecid-improves-cardiac-function-in-patients-with-heart-failure-with-reduced-ejection-fraction-in-vivo-and-cardiomyocyte-calcium-sensitivity-in-vitro
#15
Nathan Robbins, Mark Gilbert, Mohit Kumar, James W McNamara, Patrick Daly, Sheryl E Koch, Ginger Conway, Mohamed Effat, Jessica G Woo, Sakthivel Sadayappan, Jack Rubinstein
BACKGROUND: Transient receptor potential vanilloid 2 is a calcium channel activated by probenecid. Probenecid is a Food and Drug Administration-approved uricosuric drug that has recently been shown to induce positive lusitropic and inotropic effects in animal models through cardiomyocyte transient receptor potential vanilloid 2 activation. The aim of this study was to test the hypothesis that oral probenecid can improve cardiac function and symptomatology in patients with heart failure with reduced ejection fraction and to further elucidate its calcium-dependent effects on myocyte contractility...
January 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29326534/is-exercise-training-appropriate-for-patients-with-advanced-heart-failure-receiving-continuous-inotropic-infusion-a-review
#16
REVIEW
Eisuke Amiya, Masanobu Taya
Exercise-based rehabilitation programs have been reported to have beneficial effects for patients with heart failure. However, there is little evidence about whether this is the case in patients with more severe heart failure. In particular, there is a question in the clinical setting whether patients with advanced heart failure and continuous inotropic infusion should be prescribed exercise training. In contrast, many studies conclude that prolonged immobility associated with heart failure profoundly impairs physical function and promotes muscle wasting that could further hasten the course of heart failure...
2018: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/29310997/neurohormonal-imbalance-a-neglected-problem-and-potential-therapeutic-target-in-acute-heart-failure
#17
Steven R Goldsmith, Bradley A Bart, Ileana L Piña
Decompensated or acute heart failure (AHF) is characterized by increased ventricular and atrial pressures which may lead to and be caused by circulatory congestion. Unless due to a primary decrease in cardiac function, congestion arises from volume expansion or vasoconstriction. In turn, volume expansion and vasoconstriction are due to neurohormonal imbalance since both result from activation of the sympathetic nervous system, the renin-angiotensin-aldosterone axis and excess secretion of arginine vasopressin...
December 16, 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29278207/omecamtiv-mecarbil-a-myosin-motor-activator-agent-with-promising-clinical-performance-and-new-in-vitro-results
#18
Peter Nanasi, Istvan Komaromi, Marta Gaburjakova, Janos Almassy
Clinical treatment of heart failure is still suffering from limited efficacy and unfavorable side effects. The recently developed group of agents, the myosin motor activators, act directly on cardiac myosin resulting in an increased force generation and prolongation of contraction. The lead molecule, omecamtiv mecarbil is now in human phase 3. In addition to the promising clinical data published so far, there are new in vitro results indicating that the effect of omecamtiv mecarbil on contractility is rate-dependent...
December 22, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29275844/left-ventricular-assist-devices-versus-medical-management-in-ambulatory-heart-failure-patients-an-analysis-of-intermacs-profiles-4-and-5-to-7-from-the-roadmap-study
#19
Keyur B Shah, Randall C Starling, Joseph G Rogers, Douglas A Horstmanshof, James W Long, Vigneshwar Kasirajan, Josef Stehlik, Joyce Chuang, David J Farrar, Jerry D Estep
BACKGROUND: The ROADMAP study showed survival with improved functional status was better with left ventricular assist device (LVAD) therapy compared with optimal medical management (OMM) in ambulatory, non-inotrope-dependent (INTERMACS [IM] Profile 4 to 7) patients. To study more balanced cohorts and better define which patients may benefit from implantation of an LVAD, we re-evaluated the patients enrolled in ROADMAP when stratified by INTERMACS profile (Profile 4 and Profiles 5 to 7)...
December 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29273639/adverse-effects-on-%C3%AE-adrenergic-receptor-coupling-ischemic-postconditioning-failed-to-preserve-long-term-cardiac-function
#20
Rolf Schreckenberg, Péter Bencsik, Martin Weber, Yaser Abdallah, Csaba Csonka, Kamilla Gömöri, Krisztina Kiss, János Pálóczi, Judit Pipis, Márta Sárközy, Péter Ferdinandy, Rainer Schulz, Klaus-Dieter Schlüter
BACKGROUND: Ischemic preconditioning (IPC) and ischemic postconditioning (IPoC) are currently among the most efficient strategies protecting the heart against ischemia/reperfusion injury. However, the effect of IPC and IPoC on functional recovery following ischemia/reperfusion is less clear, particularly with regard to the specific receptor-mediated signaling of the postischemic heart. The current article examines the effect of IPC or IPoC on the regulation and coupling of β-adrenergic receptors and their effects on postischemic left ventricular function...
December 22, 2017: Journal of the American Heart Association
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