scholarly journals Interleukin-1 receptor-induced PGE2 production controls acetylcholine-mediated cardiac dysfunction and mortality during scorpion envenomation

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Mouzarllem B. Reis ◽  
Fernanda L. Rodrigues ◽  
Natalia Lautherbach ◽  
Alexandre Kanashiro ◽  
Carlos A. Sorgi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Dysfunction ◽  
Acetylcholine Release ◽  
Interleukin 1 ◽  
Clinical Manifestations ◽  
Prostaglandin E ◽  
High Dose ◽  
Scorpion Envenomation ◽  
Risk Of Death ◽  
Include Heart Failure

Abstract Scorpion envenomation is a leading cause of morbidity and mortality among accidents caused by venomous animals. Major clinical manifestations that precede death after scorpion envenomation include heart failure and pulmonary edema. Here, we demonstrate that cardiac dysfunction and fatal outcomes caused by lethal scorpion envenomation in mice are mediated by a neuro-immune interaction linking IL-1 receptor signaling, prostaglandin E2, and acetylcholine release. IL-1R deficiency, the treatment with a high dose of dexamethasone or blockage of parasympathetic signaling using atropine or vagotomy, abolished heart failure and mortality of envenomed mice. Therefore, we propose the use of dexamethasone administration very early after envenomation, even before antiserum, to inhibit the production of inflammatory mediators and acetylcholine release, and to reduce the risk of death.

scholarly journals The ST2 diagnostic value in selection of patients for heart transplantation and post-transplant period

2019 ◽  
Vol 40 (1) ◽  
pp. 4-11
Author(s):  
A. S. Nikonenko ◽  
O. O. Tanska
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Heart Transplantation ◽  
Prognostic Value ◽  
Clinical Manifestations ◽  
Mechanical Damage ◽  
Risk Of Death ◽  
Diagnostic And Prognostic Value

Purpose of the study. Study ST2 diagnostic marker in the development and severity of heart failure, evaluation of transplant status and the risk of developing a rejection crisis, as well as the risk of death in patients with cardiovascular disease.Material and methods. There were 41 patients under observation. The cases were conventionally divided into two groups: the first group of patients with chronic heart failure (n = 28), and the control group who performed orthotopic transplantation of the heart (n = 13).Results and discussion. These results suggest that ST2 is a real marker of chronic heart failure or a good predictor of mortality in decompensated patients. Changes in ST2 levels in patients after orthotopic cardiac transplantation may be potentially useful in detecting acute cellular rejection, as well as in controlling rejection therapy. The article is devoted to the analysis of the prognostic role of the ST2 biomarker in the pre and post-transplantation period. ST2 is one of the most promising diagnostic markers for the development and severity of heart failure, as well as the risk of death in patients with cardiovascular disease. ST2 is expressed in cardiomyocytes in response to pathological processes and various mechanical damage in the heart, which allows to diagnose cardiovascular diseases even before clinical manifestations. It is likely that ST2 level measurement of heart transplantation may have a diagnostic and prognostic value when evaluating the graft state and the risk of developing rejection.Conclusions. ST2 is one of the most promising diagnostic markers of development and severity of heart failure, as well as the risk of death in patients with cardiovascular disease. ST2 is expressed in cardiomyocytes in response to pathological processes and various mechanical damage in the heart, which allows to diagnose cardiovascular diseases even before clinical manifestations. Measuring the level of ST2 for heart transplantation may have a diagnostic and prognostic value in evaluating the condition of the graft and the risk of developing rejection. Keywords:heart failure, ST2, heart transplantation, rejection crisis.

scholarly journals Serum Free Fatty Acids Independently Predict Adverse Outcomes in Acute Heart Failure Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Yi Yu ◽  
Chunna Jin ◽  
Chengchen Zhao ◽  
Shiyu Zhu ◽  
Simin Meng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Fatty Acids ◽  
Confidence Interval ◽  
Free Fatty Acids ◽  
Cardiac Dysfunction ◽  
Adverse Outcomes ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Restricted Cubic Splines

Background: Perturbation of energy metabolism exacerbates cardiac dysfunction, serving as a potential therapeutic target in congestive heart failure. Although circulating free fatty acids (FFAs) are linked to insulin resistance and risk of coronary heart disease, it still remains unclear whether circulating FFAs are associated with the prognosis of patients with acute heart failure (AHF).Methods: This single-center, observational cohort study enrolled 183 AHF patients (de novo heart failure or decompensated chronic heart failure) in the Second Affiliated Hospital, Zhejiang University School of Medicine. All-cause mortality and heart failure (HF) rehospitalization within 1 year after discharge were investigated. Serum FFAs were modeled as quartiles as well as a continuous variable (per SD of FFAs). The restricted cubic splines and cox proportional hazards models were applied to evaluate the association between the serum FFAs level and all-cause mortality or HF rehospitalization.Results: During a 1-year follow-up, a total of 71 (38.8%) patients had all-cause mortality or HF rehospitalization. The levels of serum FFAs positively contributed to the risk of death or HF rehospitalization, which was not associated with the status of insulin resistance. When modeled with restricted cubic splines, the serum FFAs increased linearly for the incidence of death or HF rehospitalization. In a multivariable analysis adjusting for sex, age, body-mass index, coronary artery disease, diabetes mellitus, hypertension, left ventricular ejection fraction and N-terminal pro-brain natriuretic peptid, each SD (303.07 μmol/L) higher FFAs were associated with 26% higher risk of death or HF rehospitalization (95% confidence interval, 2–55%). Each increasing quartile of FFAs was associated with differentially elevated hazard ratios for death or HF rehospitalization of 1 (reference), 1.71 (95% confidence interval, [0.81, 3.62]), 1.41 (95% confidence interval, [0.64, 3.09]), and 3.18 (95% confidence interval, [1.53, 6.63]), respectively.Conclusion: Serum FFA levels at admission among patients with AHF were associated with an increased risk of adverse outcomes. Additional studies are needed to determine the causal-effect relationship between FFAs and acute cardiac dysfunction and whether FFAs could be a potential target for AHF management.

scholarly journals Revisiting the Safety of Vaccination against the Flu in Elderly Patients

2018 ◽  
Vol 6 (4) ◽  
pp. 155-161
Author(s):  
O. N. Tkacheva ◽  
A. P. Pereverzev ◽  
N. K. Runikhina ◽  
Yu. V. Kotovskaya
Keyword(s):  
Elderly Patients ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Influenza Vaccines ◽  
High Dose ◽  
Post Vaccination ◽  
Risk Of Death ◽  
Younger Age ◽  
Increased Risk ◽  
Potential Risks

Abstract. Elderly patients are at higher risk of developing infectious diseases that might have more severe progression than those of younger age groups, accompanied by an increased risk of death. These medical conditions in elderly may also present difficulties for diagnosis due to a «blurred» clinical picture. By WHO recommendations the vaccination against influenza is one of the most effective ways to prevent this type of infection in elderly patients. However the use of vaccines may be associated with a risk of adverse drug reactions. In most cases, they have subclinical manifestations and/or non-severe clinical manifestations (adverse reactions), but in a relatively small percentage of cases, the use of vaccines may be associated with a risk of developing serious post-vaccination complications (anaphylaxis, Guillain-Barre syndrome etc.). This article represents data on the safety of influenza vaccines in patients over 60 years old, with due regard to immunosenescence. According to the authors opinion, this will improve the safety of vaccination against influenza patients 60 years and older. At the end of the article, the authors conclude that despite the potential risks, the by the benefits of the use of influenza vaccines continue to overweight potential risks and vaccination of elderly people is effective and safe way to prevent influenza. To improve the effectiveness of vaccination of patients 60 years and older the use of high dose vaccines and adjuvants can be recommended.

scholarly journals A young patient with heart failure – Picture Quiz Answer

2012 ◽  
Vol 11 (1) ◽  
pp. 50-51
Author(s):  
H Patel ◽  
◽  
G Dhillon ◽  
A Bandali ◽  
Neil Patel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Death ◽  
Sinus Tachycardia ◽  
Coronary Artery Spasm ◽  
Clinical Manifestations ◽  
Histopathological Diagnosis ◽  
Non Invasive ◽  
Invasive Test ◽  
No Gold Standard ◽  
Include Heart Failure

There is no ‘gold standard’ non-invasive test to diagnose myocarditis. It is a clinico-histopathological diagnosis.1 Clinical manifestations include: heart failure, chest pain (from either pericarditis or angina from coronary artery spasm/inf lammation), sudden cardiac death and arrhythmias (sinus tachycardia, ectopics, ventricular tachycardia, heart blocks). Examination may reveal raised JVP, pulmonary crackles, a gallop rhythm or a pericardial rub.

PS2-049. Enhanced plasma Interleukin-1 activity contributes to cardiac dysfunction in heart failure

Cytokine ◽  
2011 ◽  
Vol 56 (1) ◽  
pp. 76
Author(s):  
Benjamin Van Tassell ◽  
Stefano Toldo ◽  
Eleonora Mezzaroma ◽  
Norbert Voelkel ◽  
Antonio Abbate
Keyword(s):  
Heart Failure ◽  
Cardiac Dysfunction ◽  
Interleukin 1

scholarly journals Interactions Networks for Primary Heart Sarcomas

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3882
Author(s):  
Styliani A. Geronikolou ◽  
Athanasia Pavlopoulou ◽  
George P. Chrousos ◽  
Dennis V. Cokkinos
Keyword(s):  
Heart Failure ◽  
Antiarrhythmic Drugs ◽  
Clinical Manifestations ◽  
High Confidence ◽  
P4 Medicine ◽  
Radio Therapy ◽  
Adrenergic Blockers ◽  
Heart Tumors ◽  
Artery Disease ◽  
Include Heart Failure

Personalized medicine incorporates genetic information into medical practice so as to optimize the management of chronic diseases. In rare diseases, such as heart cancer (incidence 0.0017–0.33%), this may be elusive. Ninety-five percent of the cases are due to secondary involvementwith the neoplasm originating in the lungs, breasts, kidney, blood, or skin. The clinical manifestations of heart tumors (benign or malignant) include heart failure, hypertension, and cardiac arrhythmias of varying severity, frequently resulting in blood vessel emboli, including strokes. This study aims to explain the pathophysiology and contribute to a P4 medicine model for use by cardiologists, pathologists, and oncologists. We created six gene/protein heart-related and tumor-related targets high-confidence interactomes, which unfold the main pathways that may lead to cardiac diseases (heart failure, hypertension, coronary artery disease, arrhythmias), i.e., the sympathetic nervous system, the renin-angiotensin-aldosterone axis and the endothelin pathway, and excludes others, such as the K oxidase or cytochrome P450 pathways. We concluded that heart cancer patients could be affected by beta-adrenergic blockers, ACE inhibitors, QT-prolonging antiarrhythmic drugs, antibiotics, and antipsychotics. Interactomes may elucidate unknown pathways, adding to patient/survivor wellness during/after chemo- and/or radio-therapy.

Abstract 236: Complex Patients: The Majority Hospitalized with Heart Failure also Receive Treatment for Acute Respiratory Conditions

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Kumar Dharmarajan ◽  
Kelly M Strait ◽  
Tara Lagu ◽  
Shu-Xia Li ◽  
Joanne Lynn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Treatment Guidelines ◽  
High Dose ◽  
Diagnostic Uncertainty ◽  
Risk Of Death ◽  
Autoimmune Conditions ◽  
Respiratory Treatment ◽  
Hospital Days ◽  
Respiratory Conditions

Background: Inpatients with heart failure (HF) may be treated for other acute conditions such as concomitant respiratory disease due to diagnostic uncertainty, coexisting illness, or other reasons. We investigated the frequency and mortality associated with respiratory treatments added to usual HF care. Methods: We included hospitalizations with a primary discharge diagnosis of HF from 2009-10 Premier, Inc. hospitals and age>18y, known admission source, non-pediatric attending physician, receipt of HF treatment (loop diuretics, inotropes, or IV vasodilators) and >2 day hospital stay. For hospital days 1-2 and 3-5, we noted receipt of potential respiratory treatments (short-acting inhaled bronchodilators, antibiotics, high-dose steroids). Hospitalizations with present-on-admission codes for infections besides pneumonia or inflammatory, allergic, or autoimmune conditions besides COPD were excluded. Hospitalizations were split into mutually exclusive and exhaustive groups based on treatments received in days 1-2 (table); odds of in-hospital mortality were determined for each after adjusting for age, sex, and Elixhauser comorbidities. Results: Among 164,494 HF hospitalizations, 54% (88,122) received treatment for acute respiratory conditions during hospital days 1-2 (table). At least 1 respiratory treatment was continued after day 2 in 60% (52,452) of patients who received initial treatment. Odds of in-hospital mortality increased with receipt of respiratory treatments in days 1-2 (table). Conclusions: HF inpatients are frequently treated for respiratory conditions. As these treatments are often given throughout hospitalization and identify patients at higher risk of death, coexisting comorbidities or a new cardiopulmonary syndrome may often be present, as may diagnostic uncertainty or overtreatment. Greater knowledge of patient complexity can improve treatment guidelines, patient outcomes, and risk-adjustment for performance measures.

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