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George C. Sutton, Kanu Chatterjee: Heart failure: current clinical understandingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Book ReviewDOI 10.1007/s10741-009-9155-9Authors Sidney Goldstein, Wayne State University Detroit MI USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - November 13, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Agents with inotropic properties for the management of acute heart failure syndromes. Traditional agents and beyondEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Treatment with inotropic agents is one of the most controversial topics in heart failure. Initial enthusiasm, based on strong pathophysiological rationale and apparent empirical efficacy, has been progressively limited by results of controlled trials and registries showing poorer outcomes of the patients on inotropic therapy. The use of these agents remains, however, potentially indicated in a significant proportion of patients with low cardiac output, peripheral hypoperfusion and end-organ dysfunction caused by heart failure. Limitations of inotropic therapy seem to be mainly related to their mecha...
Source: Heart Failure Reviews - October 29, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Do we have two hearts? New insights in right ventricular function supported by myocardial imaging echocardiographyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on some of the challenges related to the assessment of RV function in the setting of the RV’s unique anatomic, physiologic, conventional and newer echocardiographic aspects, and therapeutic implications. The majority of proposed methods of echocardiographic assessment of RV function are based on volumetric approximations of the RV. Such approaches have inherent limitations, first as volume-related measures such as EF are load dependent, second because of the complex geometry of the RV. The issue of RV geometry is usually overcome using geometry-independent parameters such as tricuspid annular ex...
Source: Heart Failure Reviews - October 29, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Potential of endothelin-1 and vasopressin antagonists for the treatment of congestive heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract It is now becoming clear that two major systems namely the sympathetic nervous system and the renin-angiotensin system are activated in response to ischemic injury; these result in the elevation of plasma catecholamines and angiotensin II during the development of myocardial infarction as well as congestive heart failure. Although plasma levels of several other hormones including aldosterone, endothelin, vasopressin, natriuretic peptides, growth factors and inflammatory cytokines are also increased in heart failure, their relationship with changes in catecholamine and/or angiotensin levels as well a...
Source: Heart Failure Reviews - September 18, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Architecture of the left ventricle: insights for optimal surgical ventricular restorationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The normal left ventricular shape has been defined as prolate ellipsoid. This shape is an adaptation to evolution. A knowledge of its unique macro and micro architecture forms the cornerstone in the understanding of its complex function. The left ventricle has a unique architecture with three different myofiber orientations, the longitudinal, circumferential and oblique fibers. The oblique orientation of fibers is essential for effective clockwise and anticlockwise torsional movements during systole and diastole, for optimal ventricular ejection and filling. The orientation and fiber angle decide th...
Source: Heart Failure Reviews - September 16, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Using patient DNA to optimize therapy in heart failure patients: a move toward perfectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s10741-009-9150-1Authors Howard L. McLeod, University of North Carolina UNC Institute for Pharmacogenomics and Individualized Therapy, Division of Pharmacotherapy and Experimental Therapeutics, Division of Hematology and Oncology, and the Lineberger Comprehensive Cancer Center Campus Box 7360 Chapel Hill NC 27599 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - July 6, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Role of guanylate cyclase modulators in decompensated heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract In this review we investigate the role of particulate and soluble guanylate cyclase (pGC and sGC, respectively) pathways in heart failure, and several novel drugs that modify guanylate cyclase. Nesiritide and ularitide/urodilatin are natriuretic peptides with vasodilating, natriuretic and diuretic effects, acting on pGC, whilst cinaciguat (BAY 58-2667) is a novel sGC activator. Cinaciguat has a promising and novel mode of action because it can stimulate cyclic guanosine-3′,5′-monophosphate synthesis by targeting sGC in its nitric oxide-insensitive, oxidised ferric (Fe3+) or haem-free state. Thus...
Source: Heart Failure Reviews - July 1, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Why, when, and how to assess pulmonary congestion in heart failure: pathophysiological, clinical, and methodological implicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Acute heart failure syndrome (AHFS) is a major public health problem. It is defined as gradual or rapid change in heart failure (HF) signs and symptoms, which often results in an unplanned hospitalization and a need for urgent therapy. Many evidence-based pharmacologic, device, and surgical treatment for HF are available or under development. Despite these new treatments and improvement in survival, hospitalizations in HF have steadily increased over the last 30 years, and the post-discharge prognosis of patients hospitalized with AHFS remains poor (Gheorghiade et al. Circulation 112:3958–396...
Source: Heart Failure Reviews - June 7, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Echocardiography in the assessment of left ventricular longitudinal systolic function: current methodology and clinical applicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Quantification of left ventricular (LV) systolic function represents a major aspect of echocardiographic assessment in the spectrum of cardiac diseases. However, because of the high complexity of LV contraction mechanics, the classical approach with assessment of a single measure of systolic function, such as ejection fraction or fractional shortening, has been largely superseded. During the last years, through the considerable technical advances in the field of ultrasonography, a number of different echocardiographic methodologies have become available to perform a detailed assessment of different ...
Source: Heart Failure Reviews - May 30, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Abnormalities of calcium metabolism and myocardial contractility depression in the failing heartEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Heart failure (HF) is characterized by molecular and cellular defects which jointly contribute to decreased cardiac pump function. During the development of the initial cardiac damage which leads to HF, adaptive responses activate physiological countermeasures to overcome depressed cardiac function and to maintain blood supply to vital organs in demand of nutrients. However, during the chronic course of most HF syndromes, these compensatory mechanisms are sustained beyond months and contribute to progressive maladaptive remodeling of the heart which is associated with a worse outcome. Of pathophysio...
Source: Heart Failure Reviews - May 12, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Introduction: biomarkers in heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s10741-009-9145-yAuthors Kirkwood F. Adams, University of North Carolina at Chapel Hill Departments of Medicine and Radiology, School of Medicine, UNC Heart Failure Program 730 Martin Luther King Jr Blvd Suite 207 Chapel Hill NC 27514 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - May 7, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Multi-marker strategies in heart failure: clinical and statistical approachesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Advances in genomics and proteomics promise to transform biomarker research, in which the major challenges will not be the discovery of new markers but rather the optimal selection and validation of a subgroup of clinically useful markers from the large pool of candidates. Critically, the value of new biomarkers panels will need to be assessed in the context of readily available clinical information in order to create more actionable knowledge rather than just greater complexity. Appropriate methodologies for the clinical and statistical evaluation of so called “multi-marker strategies” have not...
Source: Heart Failure Reviews - May 3, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Extracellular matrix fibrotic markers in heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Given the importance of fibrous tissue in leading to myocardial dysfunction, non-invasive assessment of fibrosis could prove a clinically useful tool in heart failure (HF) patients. Biomarkers may be used for early detection of otherwise subclinical disease, diagnostic assessment of an acute or chronic clinical syndrome, risk stratification of patients with a suspected or confirmed diagnosis, selection of an appropriate therapeutic intervention and monitoring the response to therapy. Extracellular matrix (ECM) biomarkers in HF are promising biomarkers. They are able to detect early changes in heart ...
Source: Heart Failure Reviews - April 30, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Systems biology and heart failure: concepts, methods, and potential research applicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Dramatic advances in molecular biology dominated twentieth century biomedical science and delineated the function of individual genes and molecules in exquisite detail. However, biological processes cannot be fully understood based on the properties of individual genes and molecules alone, since these elements act in concert to enable the specific functions that make for living cells and organisms. The discipline of systems biology provides a novel conceptual framework for understanding biological phenomenon. Systems biology synthesizes information concerning the interactions of genes and molecules ...
Source: Heart Failure Reviews - April 26, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Biomarker guided therapy for heart failure: focus on natriuretic peptidesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The management of heart failure remains challenging despite many therapeutic advances. Rigorous clinical trial evidence supports administration of multiple therapies, but utilization of evidence-based treatment remains inconsistent and suboptimal. Disease management programs appear effective, but remain costly and difficult to implement in today’s care system. Another approach involves optimizing therapy based on serial monitoring of cardiac biomarkers. Emerging results suggest that guiding therapy based on serial changes in natriuretic peptides may be an effective strategy. Although pilot work ha...
Source: Heart Failure Reviews - April 21, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Biomarkers of inflammation in heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Heart failure (HF) is characterized by the elaboration of a portfolio of pro-inflammatory cytokines and inflammatory mediators that are considered to contribute to disease progression by virtue of the deleterious effects that these molecules exert on the heart and circulation. Recent studies have suggested that these inflammatory mediators may serve as relevant markers of disease severity and HF prognosis. Moreover, there is evidence that changes in the levels of inflammatory biomarkers may prove useful in following the change in patient clinical status following institution of appropriate HF therap...
Source: Heart Failure Reviews - April 12, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Clinical applications of N-terminal pro B-type natriuretic peptide in heart failure and other cardiovascular diseasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract N-terminal fragment of pro B-type natriuretic peptide (NT-proBNP) has emerged as an important adjunct in the management of heart failure (HF) and other cardiovascular diseases. NT-proBNP is a 76-amino acid peptide created during cleavage of the precursor molecule, Pro B-type natriuretic peptide (ProBNP). NT-proBNP is of significant diagnostic value in patients presenting with possible HF and is an important prognostic factor in this condition and other cardiovascular diseases. Ongoing research supports the potential value of this biomarker in non-cardiovascular disease. This review will describe cli...
Source: Heart Failure Reviews - April 10, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Utility of natriuretic peptide testing in the evaluation and management of acute decompensated heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The B-type natriuretic peptide (BNP) and the amino-terminal fragment of proBNP (NT-proBNP) are increased in heart failure in proportion to severity of symptoms, degree of left ventricular dysfunction, and elevation of cardiac filling pressures. These natriuretic peptides (NPs) are increasingly used for diagnostic and prognostic purposes in acute heart failure. While NP levels on admission provide independent prognostic information, serial determinations during hospitalization and at discharge better reflect adequacy of treatment and prognosis. The addition of BNP and NT-proBNP to usual clinical deci...
Source: Heart Failure Reviews - April 10, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Perspective on the clinical application of troponin in heart failure and states of cardiac injuryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The ability to measure the appearance of cardiac specific forms of troponin in the blood represents a major advance in the clinical assessment of patients with many types of cardiovascular disease, especially acute coronary syndromes. In this review we focus on the utility of troponin in heart failure where this biomarker has emerged as an independent predictor of prognosis providing information beyond clinical assessment and measurement of b-type natriuretic peptides. The novel clinical role of troponin in a variety of states associated with myocardial injury, including chemotherapy and patients wi...
Source: Heart Failure Reviews - April 5, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

How does the heart (not) die? The role of autophagy in cardiomyocyte homeostasis and cell deathEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Autophagy plays a critical and seemingly dual-purposed role in cardiomyocytes, being implicated as a mechanism of both cellular survival, for example, during ischemia/reperfusion injury and a mechanism of cell death at stages in which progressive myocyte alterations are beyond repair. This review aims to highlight the current literature as it relates to autophagy in cardiomyocytes. It provides background into the mechanisms of cell death, discusses the details that are known about the ubiquitin proteasome system and autophagy, delves into the pathways that are known to initiate and inhibit autophagy...
Source: Heart Failure Reviews - February 25, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Istaroxime, a first in class new chemical entity exhibiting SERCA-2 activation and Na–K-ATPase inhibition: a new promising treatment for acute heart failure syndromes?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, istaroxime is a novel agent being investigated for the treatment of AHFS whose mechanism of action and cellular targets make it a promising therapy. Further studies with longer infusion times in patients with hypotension are required to confirm its efficacy and safety. Content Type Journal ArticleDOI 10.1007/s10741-009-9136-zAuthors Hashim Khan, Northwestern University, Feinberg School of Medicine Chicago IL USAMarco Metra, University of Brescia Department of Cardiology Brescia ItalyJohn E. A. Blair, Northwestern University, Feinberg School of Medicine Chicago IL USAMark Vogel, Northwestern University...
Source: Heart Failure Reviews - February 24, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Cell delivery and tracking in post-myocardial infarction cardiac stem cell therapy: an introduction for clinical researchersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Stem cell-based therapy for patients with post-infarct heart failure is a relatively new and revolutionary concept in cardiology. Despite the encouraging results from pre-clinical studies, outcomes from most clinical trials remain moderately positive while the clinical benefits are largely attributed to transplanted cell-associated paracrine effects in stimulating angiogenesis and protecting endogenous cardiomyocytes. This scenario indicates that there may be a considerably protracted iterative process of conceptual and procedural refinement before true clinical benefits can be fully materialized. A...
Source: Heart Failure Reviews - February 24, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

A novel approach to improve cardiac performance: cardiac myosin activatorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Decreased systolic function is a central factor in the pathogenesis of heart failure, yet there are no safe medical therapies to improve cardiac function in patients. Currently available inotropes, such as dobutamine and milrinone, increase cardiac contractility at the expense of increased intracellular concentrations of calcium and cAMP, contributing to increased heart rate, hypotension, arrhythmias, and mortality. These adverse effects are inextricably linked to their inotropic mechanism of action. A new class of pharmacologic agents, cardiac myosin activators, directly targets the kinetics of the...
Source: Heart Failure Reviews - February 21, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Use of a new model of transgenic mice to clarify the respective functions of thyroid hormone receptors in vivoEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract 3,5,3′-Triido-l-thyronine (T3) exerts pleiotropic actions on development and homeostasis mostly via its nuclear receptors, TRα1, TRβ1, and TRβ2, encoded by the THRA and THRB genes. Μouse genetics data outline the contrasting functions of THRA and THRB, and suggest that these are dictated by both the respective abundance of the receptor isoforms in a given cell type and the differences in the intrinsic properties of the receptors. The diversity of consequences of either hypothyroidism or THRA/THRB mutation is astonishing, suggesting that TR controls a large number of genes and that the repertoi...
Source: Heart Failure Reviews - January 10, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Cardiac hypertrophy and thyroid hormone signalingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Thyroid hormone exerts a large number of influences on the cardiovascular system. Increased thyroid hormone action increases the force and speed of systolic contraction and the speed of diastolic relaxation and these are largely beneficial effects. Furthermore, thyroid hormone has marked electrophysiological effects increasing heart rate and the propensity for atrial fibrillation and these effects are largely mal-adaptive. In addition, thyroid hormone markedly increases cardiac angiogenesis and decreases vascular tone. These multiple thyroid hormone effects are largely mediated by the action of nucl...
Source: Heart Failure Reviews - January 6, 2009 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

β-Adrenergic stimulation and myocardial function in the failing heartEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The sympathetic nervous system provides the most powerful stimulation of cardiac function, brought about via norepinephrine and epinephrine and their postsynaptic β-adrenergic receptors. More than 30 years after the first use of practolol in patients with heart failure betablockers are now the mainstay of the pharmacological treatment of chronic heart failure. Many aspects of their mechanism of action are well understood, but others remain unresolved. This review focuses on a number of questions that are key to further developments in the field. What accounts for and what is the role of β-adr...
Source: Heart Failure Reviews - December 28, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

The role of thyroid hormone in the pathophysiology of heart failure: clinical evidenceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Thyroid hormone (TH) has a fundamental role in cardiovascular homeostasis in both physiological and pathological conditions, influencing cardiac contractility, heart rate (HR), diastolic function and systemic vascular resistance (SVR) through genomic and non-genomic mediated effects. In heart failure (HF) the main alteration of thyroid function is referred to as “low-triiodothyronine (T3) syndrome” (LT3S) characterized by decreased total serum T3 and free T3 (fT3) with normal levels of thyroxine (T4) and thyrotropin (TSH). Even if commonly interpreted as an adaptive factor, LT3S may have potenti...
Source: Heart Failure Reviews - December 28, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Cardiomyocyte-specific inactivation of thyroid hormone in pathologic ventricular hypertrophy: an adaptative response or part of the problem?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Recent studies in various rodent models of pathologic ventricular hypertrophy report the re-expression of deiodinase type 3 (D3) in cardiomyocytes. D3 inactivates thyroid hormone (T3) and is mainly expressed in tissues during development. The stimulation of D3 activity in ventricular hypertrophy and subsequent heart failure is associated with severe impairment of cardiac T3 signaling. Hypoxia-induced signaling appears to drive D3 expression in the hypertrophic cardiomyocyte, but other signaling cascades implicated in hypertrophy are also capable of stimulating transcription of the DIO3 gene. Many ca...
Source: Heart Failure Reviews - December 24, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Relaxin, a pleiotropic vasodilator for the treatment of heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Relaxin is a naturally occurring peptide hormone that plays a central role in the hemodynamic and renovascular adaptive changes that occur during pregnancy. Triggering similar changes could potentially be beneficial in the treatment of patients with heart failure. The effects of relaxin include the production of nitric oxide, inhibition of endothelin, inhibition of angiotensin II, production of VEGF, and production of matrix metalloproteinases. These effects lead to systemic and renal vasodilation, increased arterial compliance, and other vascular changes. The recognition of this has led to the stud...
Source: Heart Failure Reviews - December 21, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Levosimendan: from basic science to clinical practiceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Levosimendan is a new cardiac enhancer that exerts positive inotropic effects on the failing heart mediated by calcium sensitization of contractile proteins as well as peripheral vasodilatory effects mediated by opening of ATP-sensitive potassium channels in vascular smooth-muscle cells. Levosimendan is the most well-studied calcium sensitizer in the real clinical practice, producing greater hemodynamic and symptomatic improvement in patients with acute heart failure syndromes (AHFS) than those with traditional inotropes. Immunomodulatory and anti-apoptotic properties of levosimendan may be an addit...
Source: Heart Failure Reviews - December 21, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

The role of thyroid hormone nuclear receptors in the heart: evidence from pharmacological approachesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract This review evaluates the hypothesis that the cardiac effects of amiodarone can be explained—at least partly—by the induction of a local ‘hypothyroid-like condition’ in the heart. Evidence supporting the hypothesis comprises the observation that amiodarone exerts an inhibitory effect on the binding of T3 to thyroid hormone receptors (TR) alpha-1 and beta-1 in vitro, and on the expression of particular T3-dependent genes in vivo. In the heart, amiodarone decreases heart rate and alpha myosin heavy chain expression (mediated via TR alpha-1), and increases sarcoplasmic reticulum calci...
Source: Heart Failure Reviews - December 19, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Phosphodiesterase inhibition in heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Drugs that inhibit cyclic nucleotide phosphodiesterase activity act to increase intracellular cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) content. In total, 11 families of these enzymes—which differ with respect to affinity for cAMP and cGMP, cellular expression, intracellular localization, and mechanisms of regulation—have been identified. Inhibitors of enzymes in the PDE3 family of cyclic nucleotide phosphodiesterases raise intracellular cAMP content in cardiac and vascular smooth muscle, with inotropic and, to a lesser extent, vasodilatory actions. These dr...
Source: Heart Failure Reviews - December 19, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Vasodilators in the treatment of acute heart failure: what we know, what we don’tEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Although we have recently witnessed substantial progress in management and outcome of patients with chronic heart failure, acute heart failure (AHF) management and outcome have not changed over almost a generation. Vasodilators are one of the cornerstones of AHF management; however, to a large extent, none of those currently used has been examined by large, placebo-controlled, non-hemodynamic monitored, prospective randomized studies powered to assess the effects on outcomes, in addition to symptoms. In this article, we will discuss the role of vasodilators in AHF trying to point out which are the p...
Source: Heart Failure Reviews - December 19, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

An integrated approach to managing sleep disordered breathing and cardiovascular diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will present a brief review of current processes used to diagnose and treat SDB, followed by a discussion of the overlap that exists between CVD and SDB, and present an argument that these chronic conditions should not be considered and managed as separate entities. Content Type Journal ArticleDOI 10.1007/s10741-008-9117-7Authors Robin J. Trupp, The Ohio State University College of Nursing Columbus OH USAElizabeth J. Corwin, The Ohio State University College of Nursing Columbus OH USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - December 3, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Biomarkers in heart failure: a clinical reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The diagnosis and management of heart failure remains challenging despite considerable clinical advances in recent decades. With greater understanding of the pathophysiology of this complex syndrome, a large number of candidate biomarkers have emerged and duly received scientific and clinical attention. These are frequently a measure of the degree of pathophysiological derangement or counter-regulatory processes occurring in heart failure and include biomarkers of neurohormonal activation, myocyte necrosis and myocardial remodelling amongst others. As such they may serve as an indicator of the prese...
Source: Heart Failure Reviews - December 3, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Sleep-associated movement disorders and heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Sleep-associated movement disorders are a broad group of sleep disorders characterized by involuntary movements that may disrupt sleep. Relatively little is known about the clinical consequences of sleep-associated movement disorders on cardiovascular health. Because these disorders manifest mostly during sleep, recognizing a movement disorder can be particularly difficult. Nevertheless, patients can have frequent arousals and suffer from similar sleep deprivation, fragmentation, and autonomic disruption as occurs in sleep-disordered breathing. Subsequently, these disorders may have a serious impact...
Source: Heart Failure Reviews - December 3, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Cardiac effects of thyronaminesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract 3-Iodothyronamine (T1AM) is an endogenous compound derived from thyroid hormone through decarboxylation and deiodination, which interacts with a novel G protein-coupled receptor, known as trace amine-associated receptor 1 (TAAR1). TAAR1 and other receptors of this family are expressed in several tissues, including the heart. Functional effects have been observed after administration of exogenous T1AM: in the isolated heart, a negative inotropic and chronotropic action was produced, and the resistance to ischemic injury was increased, possibly as a consequence of an action on intracellular calcium ho...
Source: Heart Failure Reviews - November 19, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Physiological consequences of the TRα1 aporeceptor stateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Many patients have been characterized harboring a mutation in thyroid hormone receptor (TR) β. Surprisingly none has yet been identified carrying a mutation in TRα1. To facilitate the identification of such patients, several animal models with a mutant TRα1 have been generated. While some phenotypic characteristics, such as an adult euthyroidism, are similar in the mutant mice, other aspects such as metabolism are quite variable. This review summarizes the most important consequences of a mutation in TRα1 in mice focusing on the TRα1-R384C mutation, and projects the insights from the animal mod...
Source: Heart Failure Reviews - November 14, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Sobetirome: a case history of bench-to-clinic drug discovery and developmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Sobetirome, also known as GC-1 and QRX-431, is a member of a class of compounds known as selective thyromimetics (Scanlan et al., Curr Opin Drug Discov Dev 4:614–622). These compounds are synthetic structural analogs of thyroid hormone that have tissue-specific thyroid hormone actions. Many of the compounds in this class, including sobetirome, also are subtype-selective thyroid hormone receptor (TR) agonists. Sobetirome selectively binds to and activates TRβ over TRα and this receptor selectivity led to the hypothesis that sobetirome would lower cholesterol through activation of liver TRβ witho...
Source: Heart Failure Reviews - November 11, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

PPAR transcriptional activator complex polymorphisms and the promise of individualized therapy for heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The PPAR gene pathway consists of interrelated genes that encode transcription factors, enzymes, and downstream targets which coordinately act to regulate cellular processes central to glucose and lipid metabolism. The pathway includes the PPAR genes themselves, other class II nuclear hormone receptor transcription factors within the PPAR family, PPAR co-activators, PPAR co-repressors, and downstream metabolic gene targets. This review focuses on the transcription factors that comprise the PPAR transcriptional activator complex—the PPARs (PPARα, PPARβ, or PPARγ), PPAR heterodimeric partners, su...
Source: Heart Failure Reviews - November 9, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Understanding the pharmacogenetic approach to warfarin dosingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Warfarin remains the drug of choice for long-term anticoagulation management in a variety of conditions. Despite an established role in prevention of thromboembolic events such as stroke, warfarin continues to be underutilized because of its association with serious drug-related adverse events. Lacking alternative therapeutic approaches, intensive research in the past decade has focused on making anticoagulation with warfarin safer. Much emphasis has been placed on defining factors associated with the wide individual variability in warfarin dose. Polymorphic sites in three genes, cytochrome P450 (CY...
Source: Heart Failure Reviews - November 9, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Introduction: vasopressin therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s10741-008-9116-8Authors David J. Whellan, Jefferson Medical College Department of Medicine, Division of Cardiology Philadelphia PA 19017 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - November 7, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Genetic variation in the natriuretic peptide system and heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Heart failure (HF) is a modern epidemic and is one of the few cardiovascular diseases which is increasing in prevalence. The growing importance of the Natriuretic Peptide (NP) system in HF is well recognized. Laboratory tests for B-type Natriuretic Peptide (BNP) have proven value as diagnostic and prognostic tools in HF and are now part of routine clinical care. Furthermore, recombinant atrial natriuretic peptide (ANP) (carperitide) and BNP (nesiritide) and are approved HF therapies in Japan and the US, respectively and additional natriuretic peptides (e.g., CNP, urodilatin, and designer NPs) are un...
Source: Heart Failure Reviews - October 11, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Obstructive sleep apnea: the new cardiovascular disease. Part I: obstructive sleep apnea and the pathogenesis of vascular diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Obstructive sleep apnea (OSA) is increasingly recognized as a novel cardiovascular risk factor. OSA is implicated in the pathogenesis of hypertension, left ventricular dysfunction, coronary artery disease and stroke. OSA exerts its negative cardiovascular consequences through its unique pattern of intermittent hypoxia. Endothelial dysfunction, oxidative stress, and inflammation are all consequences of OSA directly linked to intermittent hypoxia and critical pathways in the pathogenesis of cardiovascular disease in patients with OSA. This review will discuss the known mechanisms of vascular dysfuncti...
Source: Heart Failure Reviews - September 20, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Treatment options for hyponatremia in heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Hyponatremia is independently associated with adverse outcomes in patients with congestive heart failure (CHF). The primary cause of hyponatremia in CHF is the inappropriate secretion of the antidiuretic hormone, arginine vasopressin (AVP). The binding of AVP to V2 receptors in the renal collecting duct promotes water retention, a process that can lead to dilutional hyponatremia as well as increased ventricular preload. AVP could also exacerbate the course of CHF by interacting with V1A receptors on vascular smooth muscle cells and myocytes. Conventional treatment of hyponatremia in CHF is based larg...
Source: Heart Failure Reviews - September 9, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Rebuilding the post-infarcted myocardium by activating ‘physiologic’ hypertrophic signaling pathways: the thyroid hormone paradigmEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Viable myocardium undergoes several changes in the course of cardiac remodeling following myocardial infarction aiming to adapt the heart to the hemodynamic compromise. This response is characterized by reactivation of the fetal transcriptional program and results in cardiac dysfunction. Changes in thyroid hormone (TH)-TH receptors (TRs) axis occur in the course of post-infarction cardiac remodeling and seem to contribute to cardiac fetal phenotype. TH can “rebuild” the post-infarcted heart by preventing the fetal-like pattern of contractile proteins expression, normalizing wall tension, and opt...
Source: Heart Failure Reviews - September 5, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

AVP receptor antagonists in patients with CHFEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract In the Adhere (Acute Decompensated Heart Failure Registry) National Registry, hyponatremia (serum sodium <130 mEq/l) at clinical presentation was noted in 5% of patients with HF. The enhanced release of arginine vasopressin (AVP) can lead to hyponatremia by binding to the V2 receptor results in free-water retention and hyponatremia. Given the central role of AVP in causing hyponatremia in patients with congestive heart failure, decreasing vasopressin activity has been a therapeutic focus. With no current therapy to decrease production of AVP, attention was turned to decreasing the effec...
Source: Heart Failure Reviews - September 3, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Pharmacology of vasopressin antagonistsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Congestive heart failure (CHF) is characterized by fluid and water retention, which frequently is a therapeutic challenge. Most conventional diuretics act primarily as saluretics, i.e. they inhibit renal tubular electrolyte reabsorption, which due to osmotic pressure promotes excretion of isotonic fluid. Arginine vasopressin (AVP) via the V1A receptor vasoconstricts and via the V2 receptor promotes water reabsorption in the renal collecting duct by inserting aquaporin-2 water channels into the luminal membrane. Novel V2 receptor antagonists act as powerful aquaretics, i.e. they excrete free water. We...
Source: Heart Failure Reviews - September 3, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Insomnia and chronic heart failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options. Content Type Journal ArticleDOI 10.1007/s10741-008-9102-1Authors Don Hayes, University of Kentucky College of Medicine J410 Kentucky Clinic Departments of Pediatrics and Internal Medicine 740 South Limestone Street Lexington KY 40536 USAMichael I. Anstead, University of Kentucky College of Medicine J410 Kentucky Clinic Departments of Pediatrics and Internal Medicine 740 South Limestone Street Lexington KY 40536 USAJulia Ho, University of Kentucky HealthCare Department of Pharmacy 800 Rose Street...
Source: Heart Failure Reviews - August 30, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals

Hyponatremia in heart failure concluding remarksEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/s10741-008-9106-xAuthors Kanu Chatterjee, UCSF Norwich CT USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews)
Source: Heart Failure Reviews - August 30, 2008 Category: Cardiology Tags: Heart Failure Reviews Source Type: journals