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inotropics in heart failure

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https://www.readbyqxmd.com/read/28315072/direct-myosin-activation-by-omecamtiv-mecarbil-for-heart-failure-with-reduced-ejection-fraction
#1
Mitchell A Psotka, John R Teerlink
Myosin is the indispensable molecular motor that utilizes chemical energy to produce force for contraction within the cardiac myocyte. Myosin activity is gated by intracellular calcium levels which are regulated by multiple upstream signaling cascades that can be altered for clinical utility using inotropic medications. In contrast to clinically available cardiac inotropes, omecamtiv mecarbil is a novel direct myosin activator developed to augment left ventricular systolic function without the undesirable secondary effects of altered calcium homeostasis...
March 18, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28295363/angiotensin-ii-activates-cav-1-2-ca-2-channels-through-%C3%AE-arrestin2-and-casein-kinase-2-in-mouse-immature-cardiomyocytes
#2
Toshihide Kashihara, Tsutomu Nakada, Katsuhiko Kojima, Toshikazu Takeshita, Mitsuhiko Yamada
Angiotensin II (AngII), the main effector peptide of the renin-angiotensin system, plays important roles in cardiovascular regulation in the perinatal period. Despite the well-known stimulatory effect of AngII on vascular contraction, little is known about regulation of contraction of the immature heart by AngII. Here we found that AngII significantly increased the peak amplitude of twitch Ca(2+) transients by robustly activating L-type CaV 1.2 Ca(2+) (CaV 1.2) channels in mouse immature but not mature cardiomyocytes...
March 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28276970/advances-in-chemical-pharmacotherapy-for-managing-acute-decompensated-heart-failure
#3
Srikanth Yandrapalli, Sohaib Tariq, Wilbert S Aronow
Acute decompensated heart failure (ADHF) contributes largely to the burden of heart failure and is associated with a poorer prognosis. Although numerous clinical trials evaluated the benefit of newer medications for ADHF, most of them were not successful. Areas covered: This review focusses on the updates on recent developments in chemical pharmacotherapy for the management of ADHF. A MEDLINE search for relevant review articles and original investigations on newer drugs for ADHF provided us with necessary literature...
March 5, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28274560/antithrombin-iii-is-associated-with-acute-liver-failure-in-patients-with-end-stage-heart-failure-undergoing-mechanical-circulatory-support
#4
Judith Hoefer, Hanno Ulmer, Juliane Kilo, Raimund Margreiter, Michael Grimm, Peter Mair, Elfriede Ruttmann
OBJECTIVE: There are few data on the role of liver dysfunction in patients with end-stage heart failure supported by mechanical circulatory support. The aim of our study was to investigate predictors for acute liver failure in patients with end-stage heart failure undergoing mechanical circulatory support. METHODS: A consecutive 164 patients with heart failure with New York Heart Association class IV undergoing mechanical circulatory support were investigated for acute liver failure using the King's College criteria...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28258242/successful-cardiac-transplantation-outcomes-in-patients-with-adult-congenital-heart-disease
#5
Jonathan N Menachem, Jessica R Golbus, Maria Molina, Jeremy A Mazurek, Nicole Hornsby, Pavan Atluri, Stephanie Fuller, Edo Y Birati, Yuli Y Kim, Lee R Goldberg, Joyce W Wald
OBJECTIVES: The purpose of our study is (1) to characterise patients with congenital heart disease undergoing heart transplantation by adult cardiac surgeons in a large academic medical centre and (2) to describe successful outcomes associated with our multidisciplinary approach to the evaluation and treatment of adults with congenital heart disease (ACHD) undergoing orthotopic heart transplantation (OHT). BACKGROUND: Heart failure is the leading cause of death in patients with ACHD leading to increasing referrals for OHT...
March 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28248808/continuous-intravenous-milrinone-therapy-in-pediatric-outpatients
#6
Michelle Curley, Jill Liebers, Roy Maynard
Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy...
March 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28202884/neurohumoral-modulation-during-waon-therapy-in-chronic-heart-failure%C3%A3-subanalysis-of-waon-chf-study
#7
Tomoko Ichiki, John C Burnett, Christopher G Scott, Denise M Heublein, Masaaki Miyata, Koichiro Kinugawa, Teruo Inoue, Chuwa Tei
BACKGROUND: Heart failure (HF) is a disease of neurohumoral dysfunction and current pharmacological therapies for HF have not improved mortality rates, thus requiring additional new strategies. Waon therapy for HF patients may be a complementary strategy with peripheral vasodilation via nitric oxide. We hypothesized that Waon therapy would improve neurohumoral factors, such as natriuretic peptides (NP) and the renin-angiotensin-aldosterone system (RAAS) in HF.Methods and Results:Plasma samples were collected from patients enrolled in the WAON-CHF Study (Waon therapy (n=77) or control (n=73)) before and after the treatment...
February 16, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28198133/left-ventricular-assist-device-therapy-in-advanced-heart-failure-patient-selection-and-outcomes
#8
REVIEW
Finn Gustafsson, Joseph G Rogers
Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy...
February 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#9
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28197053/large-in-transient-left-ventricular-thrombus-due-to-anabolic-steroid-induced-cardiomyopathy
#10
Feridoun Sabzi, Reza Faraji
The presence of small or moderate size thrombosis is not uncommon in left ventricle (LV) as results of basic co-moribund disease, but huge LV thrombosis that protrudes to aortic valve in the LV outflow tract (LVOT) tract is an exceptionally rare phenomenon. We report a 34-year-old bodybuilder athlete with cardiomyopathy and massive LV thrombosis. The thrombosis extended to LVOT and protruded through the aortic valve in systole and posed a high risk of systemic emboli. The patient underwent open heart surgery, and the clot was removed...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28190602/prevention-of-acute-kidney-injury-in-intensive-care-units
#11
S Mas-Font, J Ros-Martinez, C Pérez-Calvo, P Villa-Díaz, S Aldunate-Calvo, E Moreno-Clari
Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition...
March 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28170359/targeting-%C3%AE-3-adrenergic-receptors-in-the-heart-selective-agonism-and-%C3%AE-blockade
#12
Alessandro Cannavo, Walter J Koch
Cardiac diseases, such as heart failure, remain leading causes of morbidity and mortality worldwide, with myocardial infarction as the most common etiology. HF is characterized by β-adrenergic receptor (βAR) dysregulation that is primarily due to the upregulation of G protein-coupled receptor kinases that leads to overdesensitization of β1 and β2ARs, and this clinically manifests as a loss of inotropic reserve. Interestingly, the "minor" βAR isoform, the β3AR, found in the heart, lacks G protein-coupled receptor kinases recognition sites, and is not subject to desensitization, and as a consequence of this, in human failing myocardium, the levels of this receptor remain unchanged or are even increased...
February 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28167635/defined-engineered-human-myocardium-with-advanced-maturation-for-applications-in-heart-failure-modelling-and-repair
#13
Malte Tiburcy, James E Hudson, Paul Balfanz, Susanne F Schlick, Tim Meyer, Mei-Ling Chang Liao, Elif Levent, Farah Raad, Sebastian Zeidler, Edgar Wingender, Johannes Riegler, Mouer Wang, Joseph D Gold, Itzhak Kehat, Erich Wettwer, Ursula Ravens, Pieterjan Dierickx, Linda van Laake, Marie-José Goumans, Sara Khadjeh, Karl Toischer, Gerd Hasenfuss, Larry A Couture, Andreas Unger, Wolfgang A Linke, Toshiyuki Araki, Benjamin Neel, Gordon Keller, Lior Gepstein, Joseph C Wu, Wolfram-Hubertus Zimmermann
BACKGROUND: -Advancing structural and functional maturation of stem cell-derived cardiomyocytes remains a key challenge for applications in disease modelling, drug screening, and heart repair. Here, we sought to advance cardiomyocyte maturation in engineered human myocardium (EHM) towards an adult phenotype under defined conditions. METHODS: -We systematically investigated cell composition, matrix and media conditions to generate EHM from embryonic and induced pluripotent stem cell-derived cardiomyocytes and fibroblasts with organotypic functionality under serum-free conditions...
February 6, 2017: Circulation
https://www.readbyqxmd.com/read/28160976/global-outcome-in-patients-with-left-ventricular-assist-devices
#14
Timothy J Fendler, Michael E Nassif, Kevin F Kennedy, Susan M Joseph, Scott C Silvestry, Gregory A Ewald, Shane J LaRue, Justin M Vader, John A Spertus, Suzanne V Arnold
Left ventricular assist devices (LVADs) improve survival and quality of life (QOL) for most, but not all, patients with advanced heart failure. We described a broader definition of poor outcomes after LVAD, using a novel composite of death, QOL, and other major adverse events. We evaluated the frequency of poor global outcome at 1 year after LVAD among 164 patients (86% Interagency Registry for Mechanically Assisted Circulatory Support profile 1 to 2; shock or declining despite inotropes) at a high-volume center...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28159376/the-role-of-durable-left-ventricular-assist-devices-in-advanced-heart-failure-would-my-patient-benefit
#15
Natasha Aleksova, Sharon Chih
Mechanical circulatory support improves survival and quality of life in selected patients with advanced heart failure. The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) clinical profile (profiles 1-7) is a classification system of patients with American Heart Association stage D and New York Heart Association functional class IIIb-IV heart failure. Most left ventricular assist devices (LVADs) are implanted in patients dependent on inotropes (INTERMACS 3) or whose condition is deteriorating with inotropic support (INTERMACS 2)...
November 29, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28154601/cardiac-resynchronization-therapy-device-implantation-in-a-patient-with-cardiogenic-shock-under-percutaneous-mechanical-circulatory-support
#16
Kyunghee Lim, Jin-Oh Choi, Jeong Hoon Yang, Seung-Jung Park, Sun Hwa Kim, Jiseok Kang, Hyun Sung Joh, Sun Hye Shin
65-year-old woman was admitted to our hospital with acute decompensated heart failure with reduced left ventricular ejection fraction and severe mitral regurgitation. Electrocardiography revealed a typical left bundle branch block and atrial fibrillation. Her condition deteriorated despite administering high-doses of inotropes and vasopressors. Pending a decision to therapy, venoarterial extracorporeal membrane oxygenation (ECMO) was performed when the patient underwent a cardiogenic shock. Although the hemodynamic status stabilized with ECMO support, weaning the patient from ECMO was not possible...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28134629/liguzinediol-enhances-the-inotropic-effect-of-rat-hearts-via-inhibition-of-protein-phosphatase-pp1-and-pp2a-activities
#17
Sha Li, Huili Huang, Mengdan Zhang, Wei Wang, Shuyin Xue, Ying Gao, Ming Xie, Kesu Chen, Fuming Liu, Long Chen
It has been demonstrated that Liguzinediol (LZDO), a derivative of ligustrazine from ligusticum wallichii Franch, exerts positive inotropy in isolated rat heart mediated by the sarcoplasmic reticulum Ca-ATPase (SERCA2a). Here, we further explore the underlying mechanism of the positive inotropic effect of LZDO in rat hearts. In vivo and ex vivo rat heart experiments, biochemistry and Western blot techniques were used to analyze the rat heart contractility, SERCA2a activity, phospholamban (PLB) phosphorylation and protein phosphatase (PP1 and PP2A) activities in rat left ventricular myocytes, respectively...
January 27, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28133984/new-arylsparteine-derivatives-as-positive-inotropic-drugs
#18
Vito Boido, Marcella Ercoli, Michele Tonelli, Federica Novelli, Bruno Tasso, Fabio Sparatore, Elena Cichero, Paola Fossa, Paola Dorigo, Guglielmina Froldi
Positive inotropic agents are fundamental in the treatment of heart failure; however, their arrhythmogenic liability and the increased myocardial oxygen demand strongly limit their therapeutic utility. Pursuing our study on cardiovascular activities of lupin alkaloid derivatives, several 2-(4-substituted-phenyl)-2-dehydrosparteines and 2-(4-substituted-phenyl)sparteines were prepared and tested for inotropic and chronotropic activities on isolated guinea pig atria. Four compounds (6b, 6e, 7b, and 7f) exhibited significant inotropism that, at the higher concentrations, was followed by negative inotropism or toxicity...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28119383/impact-of-heart-transplantation-on-the-functional-status-of-u-s-children-with-end-stage-heart-failure-analysis-of-data-from-the-organ-procurement-and-transplantation-network
#19
David M Peng, Yulin Zhang, David N Rosenthal, Michal Palmon, Sharon Chen, Beth D Kaufman, Katsuhide Maeda, Seth Hollander, Nancy McDonald, Leslie B Smoot, Daniel Bernstein, Christopher S Almond
BACKGROUND: -There are limited data describing the functional status (FS) of children after heart transplant (HT). We sought to describe the FS of children surviving at least one year after HT, to evaluate the impact of HT on FS, and to identify factors associated with abnormal FS post-HT. METHODS: -Organ Procurement and Transplantation Network data were used to identify all US children age <21 years surviving ≥1 year post-HT from 2005-2014 with a functional status score (FSS) available at three time points (listing, transplant, ≥1 year post-HT)...
January 24, 2017: Circulation
https://www.readbyqxmd.com/read/28117074/light-chain-cardiac-amyloidosis
#20
REVIEW
Anit K Mankad, Isata Sesay, Keyur B Shah
Cardiac amyloidosis is an underrecognized condition, in which delays to diagnosis have great implications on management options, prognosis, and morbidity. Once cardiac tissue is infiltrated by amyloid fibrils, there is a cascade of pathologic changes that can display an array of clinical manifestations, from impaired relaxation of the ventricular myocardium to severe restrictive disease or even progressive systolic heart failure. Management is guided not only by recognizing the subtype of amyloidosis (primary, hereditary, and wild-type transthyretin amyloidosis), but also the clinical stage of the disease...
November 17, 2016: Current Problems in Cancer
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