Predicting death from progressive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

1993 ◽  
Vol 72 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Leslie A. Saxon ◽  
William G. Stevenson ◽  
Holly R. Middlekauff ◽  
Gregg Fonarow ◽  
Mary Woo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Progressive Heart Failure

Abstract 416: Pluripotent Stem Cell Signaling in Pediatric Heart Failure Patients

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Kathleen C Woulfe ◽  
Phillip Tatman ◽  
Anis Karimpour-Fard ◽  
Xuan Jiang ◽  
Karin Nunley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stem Cell ◽  
Cell Signaling ◽  
Dilated Cardiomyopathy ◽  
Pediatric Patients ◽  
Disease Process ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Cytokine Signaling ◽  
Common Indication ◽  
Pediatric Heart Failure

Pediatric heart failure is a heterogeneous disease process with congenital heart disease being the most common indication for heart transplantation in infants, and dilated cardiomyopathy (DCM) the most common indication in older children. Due to limitations of studying pediatric populations, there is no specific therapy for children with DCM. Importantly, the application of proven adult therapies to pediatric patients with DCM has resulted in no substantial improvement in survival over the past three decades. Therefore, there is a clear need for new approaches to better understand this disease process. In this study, we investigated global cardiac transcriptome and circulating serum proteome changes in pediatric patients with idiopathic dilated cardiomyopathy (IDC) and non-failing controls. Changes were identified in cytokine signaling, signal transduction, and transcription in pediatric IDC patients when compared to non-failing controls. Interestingly, these changes closely resemble the induction of stem cell pluripotency and signaling in resting stem cell populations. Importantly, the transcriptome changes are age-specific and were not observed in adult IDC patients. In addition, the protein profile in serum from pediatric IDC patients identified several factors related to inflammation, and treatment of cardiomyocyte-derived induced pluripotent stem cells (iPSC) with pediatric IDC serum recapitulated pathologic changes in gene expression, including expression of genes altered in the failing pediatric heart. These findings suggest that pathologic changes in cardiomyocytes may be triggered by circulating factors present in the serum resulting in pluripotent and stem cell signaling. These results provide several novel targets for future research and therapeutic intervention.

Sustained paradoxical vasodilation during orthostasis in heart failure: a factor in the edema pathogenesis?

1994 ◽  
Vol 267 (2) ◽  
pp. H443-H448 ◽  
Author(s):  
H. Wroblewski
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Dilated Cardiomyopathy ◽  
Regional Blood Flow ◽  
Functional Class ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Pathophysiological Mechanism ◽  
Class Iii ◽  
Control Subjects ◽  
Subcutaneous Blood Flow

Baroreceptor-induced peripheral reflex vasoconstriction during upright posture is an important edema-prevention mechanism in humans. Congestive heart failure (CHF) has been associated with blunted baroreceptor control of regional blood flow during short-term head-up tilt. The effect of prolonged unloading of baroreceptors on subcutaneous blood flow of the calf was investigated in 12 healthy subjects and in 13 patients with severe idiopathic dilated cardiomyopathy (New York Heart Association functional class III or IV). The subjects were studied both supine and sitting for 3-h periods. When sitting, subcutaneous vascular resistance decreased -26 +/- 19% in CHF patients and increased 90 +/- 69% in control subjects (P < 0.0001). The corresponding subcutaneous blood flow increased 43 +/- 29% in patients with CHF compared with the decrease of -42 +/- 17% in control subjects (P < 0.0001). I conclude that patients with CHF secondary to idiopathic dilated cardiomyopathy have an abnormal baroreceptor-mediated peripheral vasodilation during orthostatic stress that is sustained for hours. This extended paradoxical vasodilation may participate as an additional pathophysiological mechanism contributing to lower extremity edema in patients with CHF.

Surgical therapy for heart failure

2018 ◽  
pp. 157-174
Author(s):  
Stephen Westaby
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Acute Coronary Syndromes ◽  
Symptomatic Relief ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Coronary Syndromes ◽  
Artery Disease ◽  
End Stage ◽  
Age Range

Congestive heart failure affects 23 million people worldwide, and is the final pathway for many diseases that affect the myocardium. Successful intervention in acute coronary syndromes together with improved management of idiopathic dilated cardiomyopathy and dysrhythmia provide an ever-increasing number of advanced heart failure patients spread over a wide age range. In Western countries, coronary artery disease is responsible for about 70% of patients with idiopathic dilated cardiomyopathy and valvular heart disease accounting for 15%. Since 10% of patients older than 65 years suffer systolic left ventricular dysfunction, the numbers with heart failure will double within the next 25 years. For end-stage patients, cardiac transplantation provides the benchmark for increased longevity and symptomatic relief. However, the vast majority of patients are over 65 years of age or are referred with established comorbidity, which precludes transplantation.

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