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inotropics in heart failure

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https://www.readbyqxmd.com/read/29923934/adenosine-plasma-level-and-a2a-receptor-expression-in-patients-with-cardiogenic-shock
#1
Mélanie Gaubert, Marion Marlinge, François Kerbaul, Noemie Resseguier, Marc Laine, Jennifer Cautella, Charlotte Cordier, Benjamin Colomb, Nathalie Kipson, Franck Thuny, Giovanna Mottola, Emmanuel Fenouillet, Jean Ruf, Franck Paganelli, Régis Guieu, Laurent Bonello
OBJECTIVES: To investigate whether adenosine A2A receptors lead to vasodilation and positive inotropic function under stimulation and whether they play a role in the control of blood pressure in patients with cardiogenic shock. DESIGN: Prospective observational study. SETTING: Monocentric, Hopital Nord, Marseille, France. SUBJECTS: Patients with cardiogenic shock (n = 16), acute heart failure (n = 16), and acute myocardial infarction (n = 16)...
June 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29923888/human-myocardium-has-a-robust-%C3%AE-1a-subtype-adrenergic-receptor-inotropic-response
#2
Paul M L Janssen, Benjamin D Canan, Ahmet Kilic, Bryan A Whitson, Anthony J Baker
Recent studies report that a single subtype of α1-adrenergic receptor (α1-AR), the α1A-subtype, mediates robust cardioprotective effects in multiple experimental models of heart failure, suggesting that the α1A-subype is a potential therapeutic target for an agonist to treat heart failure. Moreover, we recently found that the α1A-subtype is present in human heart. The goal of this study was to assess the inotropic response mediated by the α1A-subtype in human myocardium, and to determine if the response is down-regulated in myocardium from failing human heart...
May 25, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29912235/-peripartum-cardiomyopathy-a-little-known-disease
#3
Angela Beatrice Scardovi, Renata De Maria
Peripartum cardiomyopathy (PPCM) is a relatively rare cardiac disease that manifests itself in the final stage of pregnancy and in the first months after delivery in women with no previous history of cardiovascular disease. The incidence of PPCM varies widely across geographic areas and seems to be on the rise as a result of increased awareness and socioeconomic changes. PPCM recognizes a still partially undefined multifactorial etiology. Various pathogenetic hypotheses have been proposed, that range from autoimmune mechanisms to myocarditis to the hormonal hypothesis for aberrant, antiangiogenic and cardiotoxic prolactin (PRL) production, apoptosis, prolonged exposure to tocolytic drugs, malnutrition and genetic predisposition...
April 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29908289/decreased-contractility-and-altered-responses-to-inotropic-agents-in-myocytes-from-tachypacing-induced-heart-failure-canines
#4
BaoXi Gao, Yusheng Qu, Weston Sutherland, Ray W Chui, Kim Hoagland, Hugo M Vargas
Contractility measurements using primary isolated cardiac myocytes (CM) have commonly been used in understanding the physiology and pharmacology of cellular mechanics. In the majority of studies, CM from healthy animals were used, and fewer studies were performed with CM from diseased hearts. To better understand the translational value of contractility on the cellular level of a diseased animal model, myocytes were isolated from left ventricles of a tachypacing-induced heart failure (HF) canine model, and their contractility was measured by recording sarcomere shortening using an image-based IonOptix video system...
June 13, 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29907406/first-spot-urine-sodium-after-initial-diuretic-identifies-patients-at-high-risk-for-adverse-outcome-after-heart-failure-hospitalization
#5
Adriana Luk, John D Groarke, Akshay S Desai, Syed Saad Mahmood, Deepa M Gopal, Emer Joyce, Sachin P Shah, Joann Lindenfeld, Lynne Stevenson, Neal K Lakdawala
BACKGROUND: Relief of congestion is the primary goal of initial therapy for acute decompensated heart failure (ADHF). Early measurement of urine sodium concentration (UNa) may be useful to identify patients with diminished response to diuretics. The aim of this study was to determine if the first spot UNa after diuretic initiation could select patients likely to require more intensive therapy during hospitalization. METHODS: At the time of admission, 103 patients with ADHF were identified prospectively, and UNa was measured after the first dose of intravenous diuretic...
May 19, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29903518/3d-echocardiography-derived-right-ventricular-function-is-associated-with-right-ventricular-failure-and-mid-term-survival-after-left-ventricular-assist-device-implantation
#6
Harry Magunia, Clemens Dietrich, Harald F Langer, David Schibilsky, Christian Schlensak, Peter Rosenberger, Martina Nowak-Machen
BACKGROUND: Right heart failure remains a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Multiple 2D echocardiography derived parameters are associated with right ventricular failure (RV failure), but none of them has been proven to be a reliable predictor to date. We hypothesized that novel 3D-echocardiography (3DE) based parameters are associated with RV failure and predict long term outcome in patients undergoing LVAD implantation. METHODS: This single-center study retrospectively enrolled 26 patients undergoing continuous-flow LVAD implantation...
June 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29892068/suppression-of-detyrosinated-microtubules-improves-cardiomyocyte-function-in-human-heart-failure
#7
Christina Yingxian Chen, Matthew A Caporizzo, Kenneth Bedi, Alexia Vite, Alexey I Bogush, Patrick Robison, Julie G Heffler, Alex K Salomon, Neil A Kelly, Apoorva Babu, Michael P Morley, Kenneth B Margulies, Benjamin L Prosser
Detyrosinated microtubules provide mechanical resistance that can impede the motion of contracting cardiomyocytes. However, the functional effects of microtubule detyrosination in heart failure or in human hearts have not previously been studied. Here, we utilize mass spectrometry and single-myocyte mechanical assays to characterize changes to the cardiomyocyte cytoskeleton and their functional consequences in human heart failure. Proteomic analysis of left ventricle tissue reveals a consistent upregulation and stabilization of intermediate filaments and microtubules in failing human hearts...
June 11, 2018: Nature Medicine
https://www.readbyqxmd.com/read/29878942/intraoperative-hemodynamic-and-echocardiographic-measurements-associated-with-severe-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#8
Michael D Gudejko, Brian R Gebhardt, Farhad Zahedi, Ankit Jain, Janis L Breeze, Matthew R Lawrence, Stanton K Shernan, Navin K Kapur, Michael S Kiernan, Greg Couper, Frederick C Cobey
BACKGROUND: Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF. METHODS: A review of LVAD patients between March 2013 and March 2016 was performed. Severe RVF was defined by the need for a right ventricular mechanical support device, inotropic, and/or inhaled pulmonary vasodilator requirements for >14 days...
June 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29863638/characteristics-risk-factors-and-outcomes-of-extracorporeal-membrane-oxygenation-use-in-pediatric-cardiac-icus-a-report-from-the-pediatric-cardiac-critical-care-consortium-registry
#9
Marissa A Brunetti, J William Gaynor, Lauren B Retzloff, Jessica L Lehrich, Mousumi Banerjee, Venugopal Amula, David Bailly, Darren Klugman, Josh Koch, Javier Lasa, Sara K Pasquali, Michael Gaies
OBJECTIVES: Cardiopulmonary failure in children with cardiac disease differs from the general pediatric critical care population, yet the epidemiology of extracorporeal membrane oxygenation support in cardiac ICUs has not been described. We aimed to characterize extracorporeal membrane oxygenation utilization and outcomes across surgical and medical patients in pediatric cardiac ICUs. DESIGN: Retrospective analysis of the Pediatric Cardiac Critical Care Consortium registry to describe extracorporeal membrane oxygenation frequency and outcomes...
June 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29844647/the-relationship-between-serum-apelin-levels-and-the-severity-of-calcific-aortic-stenosis
#10
Hakan Duman, Ilkay Bahçeci, Hikmet Hamur, Selami Demirelli, Aziz Ramazan Dilek, Turan Erdogan, Handan Duman, Ömer Şatıroğlu, Murtaza Emre Durakoğlugil
Background: Apelin, an endogenous peptide, has recently gained attention due to its positive inotropic effects in heart failure physiopathology. We investigated the relationship between serum apelin levels and the severity of calcific aortic stenosis (AS). Methods: A total of 68 consecutive patients diagnosed with calcific AS and a control group of 32 subjects were included in the study. The subjects were divided into three group as follows: the control group, the mild-moderate AS group and the severe AS group...
May 2018: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29807676/modified-shock-index-a-bedside-clinical-index-for-risk-assessment-of-st-segment-elevation-myocardial-infarction-at-presentation
#11
Glória Abreu, Pedro Azevedo, Carlos Galvão Braga, Catarina Vieira, Miguel Álvares Pereira, Juliana Martins, Carina Arantes, Catarina Rodrigues, Alberto Salgado, Jorge Marques
INTRODUCTION: Prompt identification of higher-risk patients presenting with ST-segment elevation myocardial infarction (STEMI) is crucial to pursue a more aggressive approach. OBJECTIVE: We aimed to assess whether the modified shock index (MSI), the ratio of heart rate to mean arterial pressure, could predict six-month mortality among patients admitted with STEMI. METHODS: A retrospective observational cohort study was performed in a single center including 1158 patients diagnosed with STEMI, without cardiogenic shock on admission, between July 2009 and December 2014...
May 25, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29806100/advanced-heart-failure-a-position-statement-of-the-heart-failure-association-of-the-european-society-of-cardiology
#12
Maria G Crespo-Leiro, Marco Metra, Lars H Lund, Davor Milicic, Maria Rosa Costanzo, Gerasimos Filippatos, Finn Gustafsson, Steven Tsui, Eduardo Barge-Caballero, Nicolaas De Jonge, Maria Frigerio, Righab Hamdan, Tal Hasin, Martin Hülsmann, Sanem Nalbantgil, Luciano Potena, Johann Bauersachs, Theresa McDonagh, Petar Seferovic, Frank Ruschitzka
This article updates the Heart Failure Association of the European Society of Cardiology (ESC) 2007 classification of advanced heart failure and describes new diagnostic and treatment options for these patients. Recognizing the patient with advanced heart failure is critical to facilitate timely referral to advanced heart failure centres. Unplanned visits for heart failure decompensation, malignant arrhythmias, co-morbidities, and the 2016 ESC guidelines criteria for the diagnosis of heart failure with preserved ejection fraction are included in this updated definition...
May 27, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29777282/ambulatory-intravenous-inotropic-support-and-or-levosimendan-in-pediatric-and-congenital-heart-failure-safety-survival-improvement-or-transplantation
#13
Sotiria C Apostolopoulou, George A Vagenakis, Alexandros Tsoutsinos, Felicia Kakava, Spyridon Rammos
End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#14
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29755073/-beating-mitral-valve-replacement-for-functional-mitral-regurgitation-after-cardiac-resynchronization-therapy-report-of-a-case
#15
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754457/cardioprotective-role-of-igf-1-in-the-hypertrophied-myocardium-of-the-spontaneously-hypertensive-rats-a-key-effect-on-nhe-1-activity
#16
Alejandra M Yeves, Juan I Burgos, Andrés J Medina, M Celeste Villa-Abrille, Irene L Ennis
AIM: Myocardial Na+ /H+ exchanger-1 (NHE-1) hyperactivity and oxidative stress are interrelated phenomena playing pivotal roles in the development of pathological cardiac hypertrophy and heart failure. Exercise training is effective to convert pathological into physiological hypertrophy in the spontaneously hypertensive rats (SHR) and IGF-1 -key humoral mediator of exercise training- inhibits myocardial NHE-1, at least in normotensive rats. Therefore, we hypothesize that IGF-1 by hampering NHE-1 hyperactivity and oxidative stress should exert a cardioprotective effect in the SHR...
May 13, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29753687/istaroxime-a-positive-inotropic-agent-devoid-of-proarrhythmic-properties-in-sensitive-chronic-atrioventricular-block-dogs
#17
Alexandre Bossu, Amée Kostense, Henriette D M Beekman, Marien J C Houtman, Marcel A G van der Heyden, Marc A Vos
Current inotropic agents in heart failure therapy associate with low benefit and significant adverse effects, including ventricular arrhythmias. Istaroxime, a novel Na+ /K+ -transporting ATPase inhibitor, also stimulates SERCA2a activity, which would confer improved inotropic and lusitropic properties with less proarrhythmic effects. We investigated hemodynamic, electrophysiological and potential proarrhythmic and antiarrhythmic effects of istaroxime in control and chronic atrioventricular block (CAVB) dogs sensitive to drug-induced Torsades de Pointes arrhythmias (TdP)...
May 10, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#18
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29713934/effects-of-percutaneous-lvad-support-on-right-ventricular-load-and-adaptation
#19
Jeffrey P Yourshaw, Prabodh Mishra, M Christopher Armstrong, Bhavadharini Ramu, Michael L Craig, Adrian B Van Bakel, Daniel H Steinberg, Thomas G DiSalvo, Ryan J Tedford, Brian A Houston
Both operative and hemodynamic mechanisms have been implicated in right heart failure (RHF) following surgical left ventricular assist device (LVAD) implantation. We investigated the effects of percutaneous LVAD (pLVAD; Impella®, Abiomed) support on right ventricular (RV) load and adaptation. We reviewed all patients receiving a pLVAD for cardiogenic shock at our institution between July 2014 and April 2017, including only those with pre- and post-pLVAD invasive hemodynamic measurements. Hemodynamic data was recorded immediately prior to pLVAD implantation and up to 96 h post-implantation...
April 30, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29707029/cardiac-myosin-activators-for-heart-failure-therapy-focus-on-omecamtiv-mecarbil
#20
REVIEW
Edgardo Kaplinsky, Gordon Mallarkey
Heart failure continues to be a major global health problem with a pronounced impact on morbidity and mortality and very limited drug treatment options especially with regard to inotropic therapy. Omecamtiv mecarbil is a first-in-class cardiac myosin activator, which increases the proportion of myosin heads that are tightly bound to actin and creates a force-producing state that is not associated with cytosolic calcium accumulation. Phase I and phase II studies have shown that it is safe and well tolerated...
2018: Drugs in Context
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