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inotropics in heart failure

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https://www.readbyqxmd.com/read/28633534/neuromuscular-electrical-stimulation-improves-exercise-tolerance-in-patients-with-advanced-heart-failure-on-continuous-intravenous-inotropic-support-use-randomized-controlled-trial
#1
Patrícia Forestieri, Douglas W Bolzan, Vinícius B Santos, Rita Simone Lopes Moreira, Dirceu Rodrigues de Almeida, Renata Trimer, Flávio de Souza Brito, Audrey Borghi-Silva, Antonio Carlos de Camargo Carvalho, Ross Arena, Walter J Gomes, Solange Guizilini
OBJECTIVE: To evaluate the impact of a short-term neuromuscular electrical stimulation program on exercise tolerance in hospitalized patients with advanced heart failure who have suffered an acute decompensation and are under continuous intravenous inotropic support. DESIGN: A randomized controlled study. SUBJECTS: Initially, 195 patients hospitalized for decompensated heart failure were recruited, but 70 were randomized. INTERVENTION: Patients were randomized into two groups: control group subject to the usual care ( n = 35); neuromuscular electrical stimulation group ( n = 35) received daily training sessions to both lower extremities for around two weeks...
June 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28630772/severe-rhabdomyolysis-due-to-presumed-drug-interactions-between-atorvastatin-with-amlodipine-and-ticagrelor
#2
Iouri Banakh, Kavi Haji, Ross Kung, Sachin Gupta, Ravindranath Tiruvoipati
Atorvastatin and ticagrelor combination is a widely accepted therapy for secondary prevention of ischaemic heart disease. However, rhabdomyolysis is a well-known rare side effect of statins which should be considered when treatments are combined with cytochrome P450 3A4 enzyme inhibitors. We report a case of atorvastatin and ticagrelor associated severe rhabdomyolysis that progressed to multiorgan failure requiring renal replacement therapy, inotropes, intubation, and mechanical ventilation. Despite withdrawal of the precipitating cause and the supportive measures including renal replacement therapy, creatinine kinase increased due to ongoing rhabdomyolysis rapidly progressing to upper and lower limbs weakness...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28626160/effect-of-anemia-on-cardiovascular-hemodynamics-therapeutic-strategy-and-clinical-outcomes-in-patients-with-heart-failure-and-hemodynamic-congestion
#3
Muneyoshi Tanimura, Kaoru Dohi, Naoki Fujimoto, Keishi Moriwaki, Taku Omori, Yuichi Sato, Emiyo Sugiura, Naoto Kumagai, Shiro Nakamori, Tairo Kurita, Eitaro Fujii, Norikazu Yamada, Masaaki Ito
BACKGROUND: We investigated the effect of anemia on cardiovascular hemodynamics, therapeutic strategies and clinical outcomes in heart failure (HF) patients.Methods and Results:We divided 198 consecutive HF patients who underwent right heart catheterization before in-hospital HF treatment into 2 groups according to the presence or absence of hemodynamic congestion (HC: mean pulmonary capillary wedge pressure ≥15 mmHg and/or mean right atrial pressure ≥10 mmHg). The hemoglobin level correlated with the cardiac index (CI) and systemic vascular resistance index (SVRI) (r=-0...
June 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28611860/renal-function-and-outcomes-with-use-of-left-ventricular-assist-device-implantation-and-inotropes-in-end-stage-heart-failure-a-retrospective-single-center-study
#4
Sean Verma, Emmanuel Bassily, Shane Leighton, Rahul Mhaskar, Igor Sunjic, Angel Martin, Nancy Rihana, Tambi Jarmi, Claude Bassil
BACKGROUND: Left ventricular assist device (LVAD) and inotrope therapy serve as a bridge to transplant (BTT) or as destination therapy in patients who are not heart transplant candidates. End-stage heart failure patients often have impaired renal function, and renal outcomes after LVAD therapy versus inotrope therapy have not been evaluated. METHODS: In this study, 169 patients with continuous flow LVAD therapy and 20 patients with continuous intravenous inotrope therapy were analyzed...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28602370/the-role-of-positive-inotropic-drugs-in-the-treatment-of-older-adults-with-heart-failure-and-reduced-ejection-fraction
#5
REVIEW
Daniel J Dooley, Phillip H Lam, Ali Ahmed, Wilbert S Aronow
Positive inotropic drugs have long been studied for their potential benefits in patients with heart failure and reduced ejection fraction (HFrEF). Although there has been an extensive amount of research about the clinical effects of these drugs in general, few studies examined their effect in older patients. Therefore, there is little or no evidence to guide the use of positive inotropes in older patients with HFrEF. However, recommendations from national heart failure guidelines may be generalized to older HFrEF patients on an individual basis, taking into consideration the basic geriatric principles of pharmacotherapy: start low and go slow...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28580728/late-graft-failure-in-heart-transplant-recipients-incidence-risk-factors-and-clinical-outcomes
#6
Ángela López-Sainz, Eduardo Barge-Caballero, Gonzalo Barge-Caballero, David Couto-Mallón, María J Paniagua-Martin, Leticia Seoane-Quiroga, Carmen Iglesias-Gil, José M Herrera-Noreña, José J Cuenca-Castillo, José M Vázquez-Rodríguez, María G Crespo-Leiro
AIM: To analyse the incidence, risk factors and clinical outcomes of late graft failure after heart transplantation. METHODS AND RESULTS: We conducted an observational, single-centre study based on 547 patients who underwent cardiac transplantation from 1991 to 2014 and who survived the in-hospital postoperative period. Late graft failure was defined as the first hospitalization due to this condition after discharge. Over a mean follow-up of 8.4 ± 6, 178 (32...
June 5, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28573241/mechanisms-underlying-action-of-xinmailong-injection-a-traditional-chinese-medicine-in-cardiac-function-improvement
#7
Zhengtao Li, Sujuan Li, Lin Hu, Fang Li, Alex Chun Cheung, Weizai Shao, Yuling Que, George Pek-Heng Leung, Cui Yang
BACKGROUND: As a bioactive composite extracted from American cockroach, Xinmailong injection (XML) is used for the treatment of congestive heart failure (CHF) in China. Clinical data has provided evidence that XML has positive inotropic properties. The objective of this study was to assess the mechanisms involved in the therapeutical effect of XML on CHF. MATERIALS AND METHODS: The effects of XML on the cardiac function in isolated rat heart were measured. A Ca(2+) imaging technology was used in rat cardiomyocytes (H9c2 cells) to reveal the role of XML on Ca(2+) channels...
2017: African Journal of Traditional, Complementary, and Alternative Medicines: AJTCAM
https://www.readbyqxmd.com/read/28571618/repetitive-use-of-levosimendan-in-advanced-heart-failure-need-for-stronger-evidence-in-a-field-in-dire-need-of-a-useful-therapy
#8
Gerhard Pölzl, Johann Altenberger, Loant Baholli, Paola Beltrán, Attila Borbély, Josep Comin-Colet, Juan F Delgado, Francesco Fedele, Antonella Fontana, Friedrich Fruhwald, Gregory Giamouzis, George Giannakoulas, Martín J Garcia-González, Finn Gustafsson, Kari Kaikkonen, Matti Kivikko, Jacek Kubica, Dirk von Lewinski, Ida Löfman, Gabriella Malfatto, Nicolás Manito, Martin Martínez-Sellés, Josep Masip, Bela Merkely, Fabrizio Morandi, Henning Mølgaard, Fabrizio Oliva, Emil Pantev, Zoltán Papp, Gian Piero Perna, Roman Pfister, Vito Piazza, Ramón Bover, Diego Rangel-Sousa, Alejandro Recio-Mayoral, Alexander Reinecke, Andreas Rieth, Toni Sarapohja, Gunter Schmidt, Mirko Seidel, Stefan Störk, Bojan Vrtovec, Gerhard Wikström, Patrik Yerly, Piero Pollesello
Patients in the latest stages of heart failure are severely compromised, with poor quality of life and frequent hospitalizations. Heart transplantation and left ventricular assist device implantation are viable options only for a minority, and intermittent or continuous infusions of positive inotropes may be needed as a bridge therapy or as a symptomatic approach. In these settings, levosimendan has potential advantages over conventional inotropes (catecholamines and phosphodiesterase inhibitors), such as sustained effects after initial infusion, synergy with beta-blockers, and no increase in oxygen consumption...
May 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28553667/translation-of-cardiac-myosin-activation-with-2-deoxy-atp-to-treat-heart-failure-via-an-experimental-ribonucleotide-reductase-based-gene-therapy
#9
Kassandra S Thomson, Guy L Odom, Charles E Murry, Gregory G Mahairas, Farid Moussavi-Harami, Sam L Teichman, Xiaolan Chen, Stephen D Hauschka, Jeffrey S Chamberlain, Michael Regnier
Despite recent advances, chronic heart failure remains a significant and growing unmet medical need, reaching epidemic proportions carrying substantial morbidity, mortality, and costs. A safe and convenient therapeutic agent that produces sustained inotropic effects could ameliorate symptoms, and improve functional capacity and quality of life. We discovered small amounts of 2-deoxy-ATP (dATP) activate cardiac myosin leading to enhanced contractility in normal and failing heart muscle. Cardiac myosin activation triggers faster myosin crossbridge cycling with greater force generation during each contraction...
December 2016: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28544843/a-new-sign-of-severe-aortic-regurgitation-detected-through-airflow-analysis-in-mechanical-ventilation
#10
Juan C Garcia-Rubira, Maria J Cristo-Ropero, Manuel Almendro-Delia, Rafael Hidalgo-Urbano
A 72-year-old female with a previous history of aortic valve replacement by biological prosthesis was admitted with progressive heart failure. The clinical course was unfavorable, requiring inotropic support and invasive mechanical ventilation. Auto-triggering of the ventilator from cardiac origin has been previously described, and explained as a consequence of hyperdynamic circulation. In our case, the oscillatory movements due to the aortic regurgitation are transmitted to the airway. Early recognition of this condition can facilitate not only the correction this asynchrony in mechanical ventilation but also should raise the suspicion of aortic regurgitation...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28541596/effects-of-ivabradine-and-beta-blocker-therapy-on-dobutamine-induced-ventricular-arrhythmias
#11
Kadir Uğur Mert, Gurbet Özge Mert, Bektas Morrad, Senan Tahmazov, Fezan Mutlu, Yüksel Cavusoglu
BACKGROUND: Indirect evidences suggest that the If blocker (ivabradine) may exert an antiarrhythmic effect in ventricular myocardium in heart failure patients by inhibiting spontaneous depolarizations but the clinical relevance of this mechanism is not known. Dobutamine (DOB) has been known to increase heart rate and the incidence of cardiac arrhythmias. In this study, we evaluated the effects of ivabradine on DOB-induced ventricular arrhythmias and compared it with that of β blocker therapy...
May 25, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28536660/sorafenib-associated-heart-failure-complicated-by-cardiogenic-shock-after-treatment-of-advanced-stage-hepatocellular-carcinoma-a-clinical-case-discussion
#12
Candace Wu, Kamal Shemisa
Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28514771/istaroxime-a-potential-anticancer-drug-in-prostate-cancer-exerts-beneficial-functional-effects-in-healthy-and-diseased-human-myocardium
#13
Markus Wallner, Mounir Khafaga, Ewald Kolesnik, Aris Vafiadis, Gerold Schwantzer, Deborah M Eaton, Pero Curcic, Martin Köstenberger, Igor Knez, Peter P Rainer, Martin Pichler, Burkert Pieske, Dirk Von Lewinski
The current gold standard for prostate cancer treatment is androgen deprivation therapy and antiandrogenic agents. However, adverse cardiovascular events including heart failure can limit therapeutic use. Istaroxime, which combines Na+-K+-ATPase (NKA) inhibition with sarco/endoplasmic reticulum Ca2+-ATPase 2a (SERCA2a) stimulation, has recently shown promising anti-neoplastic effects in prostate cancer (PC) models and may also improve cardiac function. Considering the promising anticancer effects of istaroxime, we aimed to assess its functional effects on human myocardium...
April 30, 2017: Oncotarget
https://www.readbyqxmd.com/read/28506910/omecamtiv-mecarbil-activates-ryanodine-receptors-from-canine-cardiac-but-not-skeletal-muscle
#14
Péter Nánási, Marta Gaburjakova, Jana Gaburjakova, János Almássy
Due to the limited results achieved in the clinical treatment of heart failure, a new inotropic strategy of myosin motor activation has been developed. The lead molecule of myosin activator agents is omecamtiv mecarbil, which binds directly to the heavy chain of the cardiac β-myosin and enhances cardiac contractility by lengthening the lifetime of the acto-myosin complex and increasing the number of the active force-generating cross-bridges. In the absence of relevant data, the effect of omecamtiv mecarbil on canine cardiac ryanodine receptors (RyR 2) has been investigated in the present study by measuring the electrical activity of single RyR 2 channels incorporated into planar lipid bilayer...
May 13, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28501522/long-term-effects-of-flosequinan-on-the-morbidity-and-mortality-of-patients-with-severe-chronic-heart-failure-primary-results-of-the-profile-trial-after-24-years
#15
Milton Packer, Bertram Pitt, Jean-Lucien Rouleau, Karl Swedberg, David L DeMets, Lloyd Fisher
OBJECTIVES: The objective of this clinical trial was to evaluate the long-term effects of flosequinan on the morbidity and mortality of patients with severe chronic heart failure. BACKGROUND: Flosequinan was the first oral vasodilator to be used in the clinic to augment the effects of digitalis, diuretics, and angiotensin-converting enzyme inhibitors in heart failure. However, the drug activated neurohormonal systems and exerted both positive inotropic and chronotropic effects, raising concerns about its safety during long-term use...
May 2, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28496024/a-survival-case-of-fulminant-right-side-dominant-eosinophilic-myocarditis
#16
Keishi Moriwaki, Kaoru Dohi, Taku Omori, Muneyoshi Tanimura, Emiyo Sugiura, Shiro Nakamori, Toshiki Sawai, Kyoko Imanaka-Yoshida, Norikazu Yamada, Masaaki Ito
A 59-year-old Japanese woman was admitted to a nearby hospital with dyspnea and general malaise. Transthoracic echocardiography revealed right ventricular (RV) dilatation with severely reduced systolic function and leftward shift of the intraventricular septum. She was initially diagnosed with acute right heart failure, and fell into cardiogenic shock requiring an intra-aortic balloon pump and inotropic agents. An endomyocardial biopsy (EMB) demonstrated extensive interstitial edema, infiltration of inflammatory cells including numerous eosinophils, and myocytolysis with eosinophil degranulation...
May 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28486910/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. <p> Results: 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/28476660/%C3%AE-adrenergic-induced-sr-ca-2-leak-is-mediated-by-an-epac-nos-pathway
#18
Laëtitia Pereira, Dan J Bare, Samuel Galice, Thomas R Shannon, Donald M Bers
Cardiac β-adrenergic receptors (β-AR) and Ca(2+)-Calmodulin dependent protein kinase (CaMKII) regulate both physiological and pathophysiological Ca(2+) signaling. Elevated diastolic Ca(2+) leak from the sarcoplasmic reticulum (SR) contributes to contractile dysfunction in heart failure and to arrhythmogenesis. β-AR activation is known to increase SR Ca(2+) leak via CaMKII-dependent phosphorylation of the ryanodine receptor. Two independent and reportedly parallel pathways have been implicated in this β-AR-CaMKII cascade, one involving exchange protein directly activated by cAMP (Epac2) and another involving nitric oxide synthase 1 (NOS1)...
May 2, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28465311/accuracy-of-seattle-heart-failure-model-and-heartmate-ii-risk-score-in-non-inotrope-dependent-advanced-heart-failure-patients-insights-from-the-roadmap-study-risk-assessment-and-comparative-effectiveness-of-left-ventricular-assist-device-and-medical-management
#19
REVIEW
David E Lanfear, Wayne C Levy, Josef Stehlik, Jerry D Estep, Joseph G Rogers, Keyur B Shah, Andrew J Boyle, Joyce Chuang, David J Farrar, Randall C Starling
BACKGROUND: Timing of left ventricular assist device (LVAD) implantation in advanced heart failure patients not on inotropes is unclear. Relevant prediction models exist (SHFM [Seattle Heart Failure Model] and HMRS [HeartMate II Risk Score]), but use in this group is not established. METHODS AND RESULTS: ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) is a prospective, multicenter, nonrandomized study of 200 advanced heart failure patients not on inotropes who met indications for LVAD implantation, comparing the effectiveness of HeartMate II support versus optimal medical management...
May 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28451448/quality-of-life-and-long-term-mortality-in-patients-with-advanced-chronic-heart-failure-treated-with-intermittent-low-dose-intravenous-inotropes-in-an-outpatient-setting
#20
Fernando Chernomordik, Dov Freimark, Michael Arad, Michael Shechter, Shlomi Matetzky, Yulia Savir, Nir Shlomo, Amir Peled, Ilan Goldenberg, Yael Peled
AIMS: There are limited data on the effect of low-dose, intermittent inotropic therapy in an outpatient setting on the quality of life (QOL) in patients with advanced refractory heart failure (HF) symptoms. We aimed to analyse the effect of this treatment modality on QOL and subsequent survival. METHODS AND RESULTS: The study population comprised 287 consecutive patients with advanced refractory HF symptoms who were treated with low-dose, intravenous intermittent inotropic therapy in the HF Day Care Service at Sheba Medical Centre between September 2000 and September 2012...
May 2017: ESC Heart Failure
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