Phospholamban as a Therapeutic Modality in Heart Failure

2008 ◽  
pp. 156-175 ◽  
Author(s):  
Guoxiang Chu ◽  
Evangelia G. Kranias
Keyword(s):  
Heart Failure ◽  
Therapeutic Modality

scholarly journals Caregiver Burden is Low Nine to Twelve Months after Ventricular Assist Device Implantation

2016 ◽  
Author(s):  
Roxana Ghashghaei ◽  
Hao Tran ◽  
Jorge Silva ◽  
Barry H. Greenberg ◽  
Denise Barnard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Caregiver Burden ◽  
Chronically Ill ◽  
Ventricular Assist Devices ◽  
Therapeutic Modality ◽  
Ventricular Assist ◽  
Psychological Burden ◽  
Device Implantation ◽  
End Stage Heart Failure ◽  
End Stage

Background Prior studies have found that caregivers of chronically ill patients, including those with heart failure, have significant stress and burden. Ventricular Assist Devices (VADs) are a promising therapeutic modality for end stage heart failure. However, caregiver burden has not previously been studied in the caregivers of VAD patients. Methods We studied 31 caregivers of VAD patients receiving care at University of California, San Diego. Validated instruments tools, such as the Bakas Caregiving Outcomes scale and Oberst Caregiving Demand and Difficulty sub-scales, were used to measure the caregivers’ psychological burden. Results Nearly half of the caregivers were the patient’s spouse or partner (55%) with a mean age of 57 years. When evaluating caregiver burden difficulty, 23/31 (74.2%) of the caregivers experienced little to no difficulty, 5/31 (16.1%) had mild difficulty, and 3/31 (9.6%) noted moderate difficulty. When assessing caregiver burden demand, 17/31 (54.8%) experienced little to no demand, 8/31 (25.8%) reported mild to moderate, 5/31 (16.1%) noted moderate to severe, and 1/31 (3.2%) had severe demand. Using the Baka’s scale, 27/31 (87.1%) reported that VADs were not disruptive to their lives. Conclusions In this single center study, we found that 80-90% of VAD caregivers had little caregiver burden difficulty or demand, which is significantly less than published studies of caregivers of patients with other chronic diseases. Further study will be required to validate these findings and compare them to other therapies for end stage heart failure, such as cardiac transplantation.

Intermittent inotropic therapy in an outpatient setting: A cost-effective therapeutic modality in patients with refractory heart failure

1996 ◽  
Vol 132 (4) ◽  
pp. 805-808 ◽  
Author(s):  
Andres L. Marius-Nunez ◽  
Lori Heaney ◽  
Raymond N. Fernandez ◽  
William A. Clark ◽  
Anil Ranganini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cost Effective ◽  
Outpatient Setting ◽  
Therapeutic Modality ◽  
Inotropic Therapy ◽  
Refractory Heart Failure

Ultrafiltrazione peritoneale e sindrome cardiorenale: gestione del sovraccarico di fluidi e ruolo del sodio

2019 ◽  
Vol 31 (2) ◽  
pp. 100-105
Author(s):  
Luca Di Lullo ◽  
Claudio Ronco ◽  
Fulvio Floccari ◽  
Antonio De Pascalis ◽  
Rodolfo Rivera ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Diuretic Therapy ◽  
Decompensated Heart Failure ◽  
Cardiorenal Syndrome ◽  
Therapeutic Modality ◽  
Heart Failure Patients ◽  
Sodium Removal ◽  
Refractory Heart Failure ◽  
Home Based

Congestion represents a crucial clinical component of both heart failure and cardiorenal syndrome and it has been postulated to modulate heart and kidney cross-link. Diuretic therapy is a corner stone in the treatment patients with heart failure, and renal replacement therapies are mainly used for patients with refractory heart failure who have not reached the worst stages of renal disfunction. Peritoneal dialysis is a home-based therapeutic modality providing both solute clearance and ultrafiltration, together with relief from congestion in decompensated heart failure patients. The following review will focus on sodium removal in refractory decompensated heart failure patients undergoing peritoneal dialysis. (Cardionephrology)

scholarly journals Ventricular Assist Devices in Heart Failure: How to Support the Heart but Prevent Atrophy?

2014 ◽  
pp. 147-156
Author(s):  
M. POKORNÝ ◽  
L. ČERVENKA ◽  
I. NETUKA ◽  
J. PIRK ◽  
M. KOŇAŘÍK ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Data ◽  
Experimental Studies ◽  
Ventricular Assist Devices ◽  
Therapeutic Modality ◽  
Ultrastructural Changes ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Cardiac Atrophy ◽  
Mechanical Unloading

Ventricular assist devices (VAD) have recently established themselves as an irreplaceable therapeutic modality of terminal heart failure. Because of the worldwide shortage of donors, ventricular assist devices play a key role in modern heart failure therapy. Some clinical data have revealed the possibility of cardiac recovery during VAD application. On the other hand, both clinical and experimental studies indicate the risk of the cardiac atrophy development, especially after prolonged mechanical unloading. Little is known about the specific mechanisms governing the unloading-induced cardiac atrophy and about the exact ultrastructural changes in cardiomyocytes, and even less is known about the ways in which possible therapeutical interventions may affect heart atrophy. One aim of this review was to present important aspects of the development of VAD-related cardiac atrophy in humans and we also review the most significant observations linking clinical data and those derived from studies using experimental models. The focus of this article was to review current methods applied to alleviate cardiac atrophy which follows mechanical unloading of the heart. Out of many pharmacological agents studied, only the selective beta2 agonist clenbuterol has been proved to have a significantly beneficial effect on unloading-induced atrophy. Mechanical means of atrophy alleviation also seem to be effective and promising.

scholarly journals Chloroquine Decreases Cardiomyocyte Autophagy and Improves Cardiac Function in a Mouse Model of Duchenne Muscular Dystrophy

2021 ◽  
Author(s):  
Takaya Hirata ◽  
Shiro Baba ◽  
Kentaro Akagi ◽  
Daisuke Yoshinaga ◽  
Katsutsugu Umeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skeletal Muscle ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Left Ventricular ◽  
Muscle Disease ◽  
Therapeutic Modality ◽  
Cardiomyocyte Autophagy ◽  
And Function ◽  
Ventricle Size

Abstract Background: Duchenne muscular dystrophy (DMD), a severe degenerative skeletal and cardiac muscle disease, has a poor prognosis, and no curative treatments are available. Because autophagy has been reported to contribute to skeletal muscle degeneration, therapies targeting autophagy are expected to improve skeletal muscle hypofunction. However, the role of this regulatory mechanism has not been evaluated clearly in DMD cardiomyocytes. Methods: In the present study, we demonstrated that autophagy was enhanced in the cardiomyocytes of mdx mice, a model of DMD, and that increased autophagy contributed to the development of cardiomyopathy in this context. Results: As assessed by GFP-mRFP-LC3 transfection, autophagosomes were more abundant in cardiomyocytes of mdx mice compared with control wild-type (WT) mice. The number of autophagosomes was significantly enhanced by isoproterenol-induced cardiac stress (4 weeks) in cardiomyocytes of mdx but not WT mice. Simultaneously, isoproterenol increased cardiomyocyte fibrosis in mdx but not WT mice. Administration of chloroquine, an autophagy inhibitor, significantly decreased cardiomyocyte autophagy and fibrosis in mdx mice, even after isoproterenol treatment. Left ventricle size and function were evaluated by echocardiography. Left ventricular contraction was decreased in mdx mice after isoproterenol treatment compared with control mice, which was alleviated by chloroquine administration.Conclusions: These findings suggested that heart failure of DMD could be associated with autophagy. Therefore, autophagy inhibitors, such as chloroquine, are a potential therapeutic modality for heart failure in DMD patients.

Percutaneous catheter ablation of atrial fibrillation in heart failure

2018 ◽  
Vol 3 (48) ◽  
pp. 8-11
Author(s):  
Monika Kozieł ◽  
Patrycja Pruszkowska ◽  
Jakub Gumprecht ◽  
Oskar Kowalski ◽  
Zbigniew Kalarus
Keyword(s):  
Heart Failure ◽  
Catheter Ablation ◽  
Ejection Fraction ◽  
Complication Rate ◽  
Left Ventricular ◽  
Therapeutic Modality ◽  
Left Ventricular Ejection ◽  
Level Of Evidence ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction

Catheter ablation of AF has transformed from a specialized, experimental procedure into a common treatment to prevent recurrent AF. AF ablation appears to be more effective than AAD in maintaining sinus rhythm, and the complication rate is comparable to the complication rate of AAD. According to the European Society of Cardiology catheter ablation of symptomatic paroxysmal AF is recommended to decrease AF symptoms in patients who have symptomatic recurrences of AF on AAD and who prefer further rhythm control strategy (I class of recommendation, level of evidence A). Catheter ablation, compared with AAD significantly decreases recurrent AF in AF patients with heart failure with reduced ejection fraction. Some trials suggest reduced hospitalizations and mortality. However, indications for catheter ablation in HF patients should be wisely balanced and the procedures performed in experiences centers. Beyond AF recurrence, catheter ablation of AF in HF tends to be associated with improvement in left ventricular ejection fraction, exercise performance and quality of life. The method mentioned above appears to be increasingly employed as a therapeutic modality in patients with HF and AF.

B-type natriuretic hormone – the diagnostic and prognostic cardiovascular biomarker

2007 ◽  
Vol 148 (5) ◽  
pp. 217-221 ◽  
Author(s):  
Mária Lengyel
Keyword(s):  
Heart Failure ◽  
Hormone Level ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Therapeutic Modality ◽  
Natriuretic Hormone ◽  
High Brain ◽  
Cardiovascular Biomarker ◽  
Near Future ◽  
Rule Out

Brain natriuretic hormone and N-terminal-probrain natriuretic hormone are equally important cardiovascular biomarkers. Moderately increased brain natriuretic hormone level is a reliable predictor of preclinical, asymptomatic left ventricular dysfunction. Low brain natriuretic hormone levels are extensively used to rule out acute heart failure. Increased brain natriuretic hormone is associated to age, left ventricular hypertrophy, left atrial volume, atrial fibrillation, myocardial ischemia, renal failure, pulmonary hypertension, acute pulmonary embolism and progressive aortic stenosis. In chronic heart failure only high brain natriuretic hormone values support the diagnosis. High brain natriuretic hormone level, however, is an important overall cardiovascular prognostic biomarker. In the near future brain natriuretic hormone appears to be an interesting new therapeutic modality.

Successful Use of Continuous Ambulatory Peritoneal Dialysis in Refractory Heart Failure

1985 ◽  
Vol 5 (2) ◽  
pp. 127-130 ◽  
Author(s):  
Donald Kim ◽  
Ramesh Khanna ◽  
George Wu ◽  
Panos Fountas ◽  
Maurice Druck ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Enzyme Inhibitor ◽  
Severe Heart Failure ◽  
Therapeutic Modality ◽  
Sodium Balance ◽  
Variable Degree ◽  
Volume Depletion ◽  
Acute Dialysis

Four patients with end-stage heart failure, massive ascites refractory to medical interventions and a variable degree of renal failure were treated successfuly with CAPD for eight to 24 months. The New York Heart Association functional class improved in all four. In two patients, who presented initially with signs and symptoms mainly of right-sided heart failure, ejection fraction improved. Each day dialysis achieved a significant degree of ultrafiltration and a negative sodium balance. We propose that CAPD is an alternative therapeutic modality in patients with severe heart failure refractory to the conventional medical treatment. The advent of potent diuretics and preload and afterload reducing agents has had a major impact in the treatment of refractory congestive heart failure. Recently, captopril, an angiotensinconverting enzyme inhibitor, has been used with major benefit in some patients (I). However, some patients still do not respond to these treatments and their management presents a major therapeutic challenge. Furthermore, overzealous therapy with diuretics may lead to intravascular volume depletion resulting in hypotension, azotemia and electrolyte disturbances which further complicate their management. In the past, intermittent peritoneal dialysis (IPD) or hemodialysis (HD) has been used to remove fluid from patients with intractable edema due to heart failure (2 7). But the benefit is only transient and fluid accumulates again, requiring repeated sessions of acute dialysis. However, hypotension is a frequent complication during either form of acute dialysis especially in hemodynamically unstable patients due to rapid removal of large amounts of fluid from intravascular space. Continuous ambulatory peritoneal dialysis (CAPD), whose main characteristic is the slow continuous removal of sodium and water, offers obvious advantages in patients with intractable heart failure. This paper describes our experience of four patients with intractable heart failure who have been treated with CAPD for eight to 24 months.

scholarly journals Office wall color influence on subjective response in patients with chronic heart failure

2020 ◽  
Vol 2 (2) ◽  
pp. 108-113
Author(s):  
Aida Botonjic Karahusic ◽  
Nedim Begic ◽  
Edin Begic ◽  
Sabina Kusljugic ◽  
Damir Secic
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Stroke Volume ◽  
Pharmacological Treatment ◽  
Heart Muscle ◽  
Therapeutic Modality ◽  
Clinical State ◽  
Subjective Response ◽  
Work Activity ◽  
Subjective State

Heart failure is defined as a clinical state, which occurs as a result of structural or functional damage of ventricle with consequential blood hypo perfusion of organs (reduced stroke volume of heart muscle and/or increased intracardial pressure in rest or during work activity). Therapeutical monitoring of patient is imperative, and it includes assessment of objective and subjective state of patient, which is often guide for optimizing of pharmacological treatment. The aim of paper is assessment of the room wall color influence as one of the factor for optimizing the therapeutic modality of patients with diagnosis of heart failure. Findings suggest that the influence of color in environment can be neutral, enabling or disabling, and this is the aspect of treatment that needs to be investigated further in future. 

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