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inotropics in heart failure

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https://www.readbyqxmd.com/read/28202884/neurohumoral-modulation-during-waon-therapy-in-chronic-heart-failure%C3%A3-subanalysis-of-waon-chf-study
#1
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
#2
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
#3
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
#4
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
#5
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...
February 9, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28170359/targeting-%C3%AE-3-adrenergic-receptors-in-the-heart-selective-agonism-and-%C3%AE-blockade
#6
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
#7
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
#8
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...
January 5, 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
#9
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
#10
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
#11
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
#12
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
#13
David 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
#14
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
https://www.readbyqxmd.com/read/28105408/predictors-of-prolonged-mechanical-ventilation-in-pediatric-patients-after-cardiac-surgery-for-congenital-heart-disease
#15
Avisa Tabib, Seyed Ehsan Abrishami, Mohammad Mahdavi, Hojjat Mortezaeian, Ziae Totonchi
BACKGROUND: The duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers. OBJECTIVES: The current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28096047/cellular-basis-of-angiotensin-1-7-induced-augmentation-of-left-ventricular-functional-performance-in-heart-failure
#16
Xiaowei Zhang, Heng-Jie Cheng, Peng Zhou, Dalane W Kitzman, Carlos M Ferrario, Wei-Min Li, Che Ping Cheng
BACKGROUND: Angiotensin-(1-7) [Ang-(1-7)] exhibits cardiovascular effects opposite those of angiotensin II (Ang II), thus providing protection against heart disease. However, how Ang-(1-7) imparts cardioprotection is unclear, and its direct cardiac effects are controversial. Whether heart failure (HF) alters cardiac contractile responses to Ang-(1-7) remains undetermined. We tested the hypothesis that in HF, Ang-(1-7) may produce positive modulation on [Ca(2+)]i regulation, enhancing left ventricular (LV) and myocyte contraction and relaxation via Ang-(1-7) Mas receptor coupled with nitric oxide (NO)/bradykinin (BK)-mediated mechanism...
January 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088894/clinical-significance-of-the-sympathetic-nervous-system-in-the-development-and-progression-of-pulmonary-arterial-hypertension
#17
Ru-Xia Liu, Qian Luo, Hui Qiao, Juan Yu, Qian-Long Zhang, Peng Wang, Yong-Gang Cao, Chang-Lin Jiang, Li-Hui Qu
Pulmonary arterial hypertension (PAH) is defined as a complex disease of clinically characterized by elevated pulmonary pressure eventually resulting in right heart failure and premature death. To date, PAH still remains a life-threatening disease. Published evidence suggests that patients with PAH present profound sympathetic nervous system abnormalities and sympathetic activity has been shown to be increased. The mechanism of PAH is still complex and poorly understood. Some data have showed that adrenoceptors are involved in the process of the pathology and have different functions in the progression of PAH followed by heart failure...
January 12, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28087308/myocardial-inotropic-reserve-an-old-twist-that-constitutes-a-reliable-index-in-the-modern-era-of-heart-failure
#18
REVIEW
Fragkiskos Parthenakis, Spyridon Maragkoudakis, Maria Marketou, Alexandros Patrianakos, Evaggelos Zacharis, Panos Vardas
Current national and international guidelines, including those of the European Society of Cardiology, recognize that the assessment of prognosis should be a part of the standard management for patients with chronic heart failure (CHF). However, these same guidelines recognize the inherent difficulty of this process. A variety of factors contribute to this difficulty, including the varying etiology, frequent co-morbidity and, perhaps most importantly, huge inter-individual variability in the disease progression and outcome...
November 22, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#19
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28070237/to-ventricular-assist-devices-or-not-when-is-implantation-of-a-ventricular-assist-device-appropriate-in-advanced-ambulatory-heart-failure
#20
EDITORIAL
Emily Cerier, Brent C Lampert, Arman Kilic, Asia McDavid, Salil V Deo, Ahmet Kilic
Advanced heart failure has been traditionally treated via either heart transplantation, continuous inotropes, consideration for hospice and more recently via left ventricular assist devices (LVAD). Heart transplantation has been limited by organ availability and the futility of other options has thrust LVAD therapy into the mainstream of therapy for end stage heart failure. Improvements in technology and survival combined with improvements in the quality of life have made LVADs a viable option for many patients suffering from heart failure...
December 26, 2016: World Journal of Cardiology
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