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inotropics in heart failure

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https://www.readbyqxmd.com/read/28105408/predictors-of-prolonged-mechanical-ventilation-in-pediatric-patients-after-cardiac-surgery-for-congenital-heart-disease
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28045338/systolic-mitral-annulus-velocity-is-a-sensitive-index-for-changes-in-left-ventricular-systolic-function-during-inotropic-therapy-in-patients-with-acute-heart-failure
#7
Trygve Husebye, Jan Eritsland, Reidar Bjørnerheim, Geir Ø Andersen
BACKGROUND: Echocardiography is recommended for assessment of left ventricular systolic function in patients with acute heart failure but few randomised trials have validated techniques like tissue Doppler (TDI) and speckle tracking (STE) in patients with acute heart failure following ST-elevation myocardial infarction. METHODS: This was a substudy from the LEAF (LEvosimendan in Acute heart Failure following myocardial infarction) trial (NCT00324766 ), which randomised 61 patients developing acute heart failure, including cardiogenic shock, within 48 hours after ST-elevation myocardial infarction, double-blind to a 25-hour infusion of levosimendan or placebo...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#8
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
December 30, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28017351/cost-effectiveness-of-left-ventricular-assist-devices-in-ambulatory-patients-with-advanced-heart-failure
#9
Jacqueline Baras Shreibati, Jeremy D Goldhaber-Fiebert, Dipanjan Banerjee, Douglas K Owens, Mark A Hlatky
OBJECTIVES: This study assessed the cost-effectiveness of left ventricular assist devices (LVADs) as destination therapy in ambulatory patients with advanced heart failure. BACKGROUND: LVADs improve survival and quality of life in inotrope-dependent heart failure, but data are limited as to their value in less severely ill patients. METHODS: We determined costs of care among Medicare beneficiaries before and after LVAD implantation from 2009 to 2010...
November 30, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/28017176/levosimendan-as-a-treatment-for-acute-renal-failure-associated-with-cardiogenic-shock-after-hip-fracture
#10
Fabiola Quinteros Hinojosa, Margarita Revelo, Alexander Salazar, Genaro Maggi, Renato Schiraldi, Nicolas Brogly, Fernando Gilsanz
Inotropic drugs are part of the treatment of heart failure; however, inotropic treatment has been largely debated due to the increased incidence of adverse effects and increased mortality. Recently levosimendan, an inotropic positive agent, has been proved to be effective in acute heart failure, reducing the mortality and improving cardiac and renal performance. We report the case of a 75-year-old woman with history of heart and renal failure and hip fracture. Levosimendan was used in preoperative preparation as an adjuvant therapy, to improve cardiac and renal function and to allow surgery...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28007527/applications-of-higenamine-in-pharmacology-and-medicine
#11
REVIEW
Nana Zhang, Zeqin Lian, Xueying Peng, Zijian Li, Haibo Zhu
ETHNOPHARMACOLOGICAL RELEVANCE: Aconitum has been used as local and traditional medicines in many asian regions for the treatment of various diseases such as collapse, syncope, painful joints, oedema, bronchial asthma et al. Higenamine, a plant-based alkaloid, was initially isolated from Aconitum and identified as the active cardiotonic component of Aconitum. It has been tested as a candidate of pharmacologic stress agent in the detection of coronary artery diseases (CADs) and now researchers have just accomplished the phase III clinical studies successfully in China...
January 20, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27982348/a-cycle-ergometer-exercise-program-improves-exercise-capacity-and-inspiratory-muscle-function-in-hospitalized-patients-awaiting-heart-transplantation-a-pilot-study
#12
Patrícia Forestieri, Solange Guizilini, Monique Peres, Caroline Bublitz, Douglas W Bolzan, Isadora S Rocco, Vinícius B Santos, Rita Simone L Moreira, João R Breda, Dirceu R de Almeida, Antonio Carlos de C Carvalho, Ross Arena, Walter J Gomes
Objective: The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods: Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11) - conventional protocol; and 2) Intervention Group (n=7) - stationary cycle ergometer exercise training...
September 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27979033/bendopnea-and-risk-of-adverse-clinical-outcomes-in-ambulatory-patients-with-systolic-heart-failure
#13
Jennifer T Thibodeau, Benjamin E Jenny, Jeomi O Maduka, Punag H Divanji, Colby R Ayers, Faris Araj, Alpesh A Amin, Robert M Morlend, Pradeep P A Mammen, Mark H Drazner
BACKGROUND: Recently, the symptom of bendopnea, that is, shortness of breath when bending forwards such as when putting on shoes, has been described in heart failure patients and found to be associated with higher ventricular filling pressures, particularly in the setting of low cardiac index. However, it is not known whether bendopnea is associated with clinical outcomes. METHODS: In a prospective convenience sample of 179 patients followed in our heart failure disease management clinic, we determined the presence of bendopnea at the time of enrollment and ascertained clinical outcomes through 1 year of follow-up...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#14
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27931542/risk-profile-and-in-hospital-prognosis-in-elderly-patients-presenting-for-acute-st-elevation-myocardial-infarction-in-the-tunisian-context
#15
Walid Jomaa, Sonia Hamdi, Imen Ben Ali, Mohamed A Azaiez, Aymen El Hraiech, Khaldoun Ben Hamda, Faouzi Maatouk
OBJECTIVES: Little is known about the risk profile and in-hospital prognosis of elderly patients presenting for ST-elevation myocardial infarction (STEMI) in Tunisia. We sought to determine in-hospital prognosis of elderly patients with STEMI in a Tunisian center. METHODS: The study was carried out on a retrospective registry enrolling 1403 patients presenting with STEMI in a Tunisian center between January 1998 and January 2013. Patients ≥75 years old were considered elderly...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#16
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#17
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27895488/advances-in-the-management-of-heart-failure-the-role-of-ivabradine
#18
REVIEW
Ursula Müller-Werdan, Georg Stöckl, Karl Werdan
A high resting heart rate (≥70-75 b.p.m.) is a risk factor for patients with heart failure (HF) with reduced ejection fraction (EF), probably in the sense of accelerated atherosclerosis, with an increased morbidity and mortality. Beta-blockers not only reduce heart rate but also have negative inotropic and blood pressure-lowering effects, and therefore, in many patients, they cannot be given in the recommended dose. Ivabradine specifically inhibits the pacemaker current (funny current, If) of the sinoatrial node cells, resulting in therapeutic heart rate lowering without any negative inotropic and blood pressure-lowering effect...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27882023/effects-of-bisoprolol-in-combination-with-trimetazidine-on-the-treatment-of-heart-failure-and-concomitant-chronic-obstructive-pulmonary-disease
#19
Yuanyuan Ke, Dingli Xu, Minxiong Li, Zenglong Wu, Yongpeng Huang
OBJECTIVE: To evaluate the effects of bisoprolol combined with trimetazidine on the treatment of heart failure patients having concomitant chronic obstructive pulmonary disease (COPD); in comparison with control group treated with standard therapy only. METHODS: A total of 120 heart failure patients having concomitant COPD were selected and randomly divided into a control group and a treatment group according to different treatment methods (n=60). The control group was given continuous low flow oxygen inhalation and inotropic agents, and their cardiac stress was also reduced...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#20
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
January 2017: Canadian Journal of Cardiology
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