Effects of ibuprofen and pentoxifylline on the cardiovascular response of normal humans to endotoxin

1992 ◽  
Vol 73 (3) ◽  
pp. 925-931 ◽  
Author(s):  
G. D. Martich ◽  
M. M. Parker ◽  
R. E. Cunnion ◽  
A. F. Suffredini
Keyword(s):  
Cardiovascular Response ◽  
Resistance Index ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Oxygen Extraction Ratio ◽  
Ventricular Ejection Fraction ◽  
Endotoxin Administration ◽  
Systolic Volume ◽  
Hemodynamic Variables

Endotoxin is a major mediator of the life-threatening cardiovascular dysfunction that characterizes Gram-negative sepsis. In animal models of endotoxemia, pretreatment with ibuprofen or pentoxifylline attenuates some of these cardiovascular changes. To evaluate the effects of these agents on the human cardiovascular response to endotoxemia, hemodynamic variables were measured serially in 24 normal subjects who were given intravenous endotoxin. The subjects were randomized to receive oral ibuprofen (n = 9), pentoxifylline (n = 10), or no medication before endotoxin administration (n = 5). The subjects were volume loaded 3–5 h after endotoxin administration, and hemodynamic measurements were reassessed. Core temperature after endotoxin alone or endotoxin-pentoxifylline approached a maximum at 3 h (greater than or equal to 38.6 degrees C), while the endotoxin-ibuprofen group remained afebrile. At 3 and 5 h, all three groups had significant increases in heart rate, cardiac index, oxygen delivery, and oxygen consumption, while systemic vascular resistance index decreased significantly from baseline. The oxygen extraction ratio remained unchanged. After volume loading, the left ventricular ejection fraction and left ventricular end-diastolic and end-systolic volume indexes did not differ among the groups. The hyperdynamic cardiovascular response to endotoxin in humans occurs in the absence of fever and is not significantly ameliorated by oral cyclooxygenase or phosphodiesterase inhibition.

scholarly journals Assessment of Regional Left Ventricular Myocardial Strain in Patients with Left Anterior Descending Coronary Stenosis Using Computed Tomography Feature Tracking

2020 ◽  
Author(s):  
Xiaoyu Han ◽  
Yukun Cao ◽  
Zhiguo Ju ◽  
Jia Lu ◽  
Na Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Feature Tracking ◽  
Systolic Function ◽  
Myocardial Strain ◽  
Normal Subjects ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
Group I

Abstract Background Computed Tomography feature tracking (CT-FT) has emerged as a valuable method for the assessment of cardiac function. However, there have been no study about the usefulness of CT-derived assessments of left ventricular strain on coronary artery disease (CAD). Our aim was to evaluate the regional left ventricular (LV) systolic deformation in patients with left anterior descending coronary (LAD) stenosis using CT-FT. Methods Seventy-six patients with LAD stenosis were enrolled. The patients were divided into four groups according to the percentage of LAD stenosis: ≤25% was defined as group I (24 patients), 26–49% as group II (17 patients), 50–74% as group III (21 patients), and ≥ 75% as group IV (14 patients).Thirty-two sex- and age-matched normal subjects were included as controls. Results No intergroup differences were found between groups I-IV and the controls in terms of the left ventricular ejection fraction, end-diastolic volume and end-systolic volume. However, the longitudinal strain (LS) of the LAD territory was significantly reduced in groups I-IV compared with the controls (-20.8% and − 18.5% and − 18.6% and − 17.0% vs -23.7%, respectively). The circumferential strain (CS) of the LAD territory was significantly reduced in groups III and IV compared with the controls and groups I and II (-22.4% and − 22.2% vs -25.4% and − 24.1% and − 25.3%, respectively). Compared with non-LAD territory, groups II-IV had significantly increased LS (-19.9% vs -21%; -18.6% vs -21.9%; -16.4% vs -20.1%). The severity of LAD stenosis had a positive correlation with the LS of the LAD territory (r = 0.438, p = 0.002). Conclusion CT‑FT can detect decreasing LV systolic function in patients with LAD stenosis. With the increasing severity of LAD stenosis, the LV regional systolic deformation of the LAD territory was reduced.

A Systematic Review and Meta-analysis : Safety and Efficacy of Mesenchymal stem Cells Therapy for Heart Failure

2020 ◽  
Vol 15 ◽  
Author(s):  
Tiantian Shen ◽  
Lin Xia ◽  
Wenliang Dong ◽  
Jiaxue Wang ◽  
Feng Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Safety And Efficacy ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume

Background: Preclinical and clinical evidence suggests that mesenchymal stem cells (MSCs) may be beneficial in treating heart failure (HF). However, the effects of stem cell therapy in patients with heart failure is an ongoing debate and the safety and efficacy of MSCs therapy is not well-known. We conducted a systematic review of clinical trials that evaluated the safety and efficacy of MSCs for HF. This study aimed to assess the safety and efficacy of MSCs therapy compared to the placebo in heart failure patients. Methods: We searched PubMed, Embase, Cochrane library systematically, with no language restrictions. Randomized controlled trials(RCTs) assessing the influence of MSCs treatment function controlled with placebo in heart failure were included in this analysis. We included RCTs with data on safety and efficacy in patients with heart failure after mesenchymal stem cell transplantation. Two investigators independently searched the articles, extracted data, and assessed the quality of the included studies. Pooled data was performed using the fixed-effect model or random-effect model when it appropriate by use of Review Manager 5.3. The Cochrane risk of bias tool was used to assess bias of included studies. The primary outcome was safety assessed by death and rehospitalization and the secondary outcome was efficacy which was assessed by six-minute walk distance and left ventricular ejection fraction (LVEF)，left ventricular end-systolic volume（LVESV），left ventricular end-diastolic volume（LVEDV） and brain natriuretic peptide（BNP） Results: A total of twelve studies were included, involving 823 patients who underwent MSCs or placebo treatment. The overall rate of death showed a trend of reduction of 27% (RR [CI]=0.73 [0.49, 1.09], p=0.12) in the MSCs treatment group. The incidence of rehospitalization was reduced by 47% (RR [CI]=0.53[0.38, 0.75], p=0.0004). The patients in the MSCs treatment group realised an average of 117.01m (MD [95% CI]=117.01m [94.87, 139.14], p<0.00001) improvement in 6MWT.MSCs transplantation significantly improved left ventricular ejection fraction (LVEF) by 5.66 % (MD [95% CI]=5.66 [4.39, 6.92], p<0.00001), decreased left ventricular end-systolic volume (LVESV) by 14.75 ml (MD [95% CI]=-14.75 [-16.18, -12.83], p<0.00001 ) and left ventricular end-diastolic volume (LVEDV) by 5.78 ml (MD [95% CI]=-5.78[-12.00, 0.43], p=0.07 ) ,in the MSCs group , BNP was decreased by 133.51 pg/ml MD [95% CI]= -133.51 [-228.17,-38.85], p=0.54, I2= 0.0%) than did in the placebo group. Conclusions: Our results suggested that mesenchymal stem cells as a regenerative therapeutic approach for heart failure is safe and effective by virtue of their self-renewal potential, vast differentiation capacity and immune modulating properties. Allogenic MSCs have superior therapeutic effects and intracoronary injection is the optimum delivery approach. In the tissue origin, patients who received treatment with umbilical cord MSCs seem more effective than bone marrow MSCs. As to dosage injected, (1-10)*10^8 cells were of better effect.

scholarly journals EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
C Rios-Navarro ◽  
J Gavara ◽  
J Nunez ◽  
C Bonanad Lozano ◽  
E Revuelta-Lopez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Microvascular Obstruction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” Bachground. Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in endothelium adhesion, is an understudied area in the MVO setting. Purpose. We aimed to evaluate whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. Methods. We prospectively included 106 patients with a first STEMI treated with primary percutaneous coronary intervention, quantifying serum levels of EpCAM 24 hours post-reperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction (LVEF) was evaluated. Results. The mean age of the sample was 59 ± 13 years and 76% were male. Patients were dichotomized according to EpCAM median (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (p-value = 0.02) and greater infarct size (p-value = 0.02). At presentation, only EpCAM values were significantly associated with the presence of MVO in univariate (Odds Ratio [95% confidence interval] (OR [95% CI]): 0.58 [0.38-0.88], p-value = 0.01) and multivariate logistic regression models (OR [95% CI]: 0.54 [0.34-0.85], p-value = 0.007). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: depressed LVEF (p-value = 0.009) and higher left ventricular end-systolic volume (p-value = 0.04). Conclusions. EpCAM is associated with occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI. Future studies are needed to confirm EpCAM as biomarker, and eventually biotarget in STEMI pathophysiology.

scholarly journals Early Elevation of Systemic Plasma Clusterin after Reperfused Acute Myocardial Infarction in a Preclinical Porcine Model of Ischemic Heart Disease

2020 ◽  
Vol 21 (13) ◽  
pp. 4591
Author(s):  
Denise Traxler ◽  
Andreas Spannbauer ◽  
Patrick Einzinger ◽  
Julia Mester-Tonczar ◽  
Dominika Lukovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Late Enhancement ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
End Diastolic Volume

Clusterin exerts anti-inflammatory, cytoprotective and anti-apoptotic effects. Both an increase and decrease of clusterin in acute myocardial infarction (AMI) has been reported. We aimed to clarify the role of clusterin as a systemic biomarker in AMI. AMI was induced by percutaneous left anterior artery (LAD) occlusion for 90 min followed by reperfusion in 24 pigs. Contrast ventriculography was performed after reperfusion to assess left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) and additional cMRI + late enhancement to measure infarct size and LV functions at day 3 and week 6 post-MI. Blood samples were collected at prespecified timepoints. Plasma clusterin and other biomarkers (cTnT, NT-proBNP, neprilysin, NGAL, ET-1, osteopontin, miR21, miR29) were measured by ELISA and qPCR. Gene expression profiles of infarcted and remote region 3 h (n = 5) and 3 days (n = 5) after AMI onset were analysed by RNA-sequencing. AMI led to an increase in LVEDV and LVESV during 6-week, with concomitant elevation of NT-proBNP 3-weeks after AMI. Plasma clusterin levels were increased immediately after AMI and returned to normal levels until 3-weeks. Plasma NGAL, ET-1 and miR29 was significantly elevated at 3 weeks follow-up, miR21 increased after reperfusion and at 3 weeks post-AMI, while circulating neprilysin levels did not change. Elevated plasma clusterin levels 120 min after AMI onset suggest that clusterin might be an additional early biomarker of myocardial ischemia.

P3550Changes in intrarenal venous flow and right ventricle-pulmonary circulation coupling from in-hospital admission to discharge in decompensated heart failure patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Labate ◽  
A Vella ◽  
G Carenini ◽  
M Losito ◽  
M M Caracciolo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricle ◽  
Pulmonary Circulation ◽  
Laboratory Tests ◽  
Resistance Index ◽  
Resistive Index ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Venous Blood Flow ◽  
Ventricular Ejection Fraction

Abstract Background Intrarenal venous blood flow (IRVF) has been used to assess renal haemodynamics in heart failure (HF). In stable euvolemic HF patients, IRVF patterns are correlated with clinical outcomes independently of conventional prognostic factors. No studies are available about the use of IRVF in decompensated HF (DHF). Purpose We aimed at establishing the possible clinical use of IRVF and his relationship with right ventricle (RV)-pulmonary circulation (PC) coupling in a cohort of DHF patients admitted at our clinic. Methods 15 DHF patients (mean age 72.6±9.8 years) with signs and symptoms of volume overload underwent a transthoracic echocardiography followed by renal ultrasonography and routine laboratory tests at admission and at pre-discharge (in stable euvolemic state after diuretic treatment). The IRVF was evaluated by Venous Impedance Index (VII). Results At discharge after depletive treatment resulted in clinical decongestion, we observed a reduction of VII (from 0.74±0.28 to 0.42±0.40; p=0.016) associated with reduction of pulmonary pressures and better RV to PC coupling (TAPSE/PASP ratio from 0.33±0.18 to 0.46±0.15; p=0.031). No significant differences in resistive index (RI), LVEF and renal function laboratory tests were detected. Results are shown in Table 1. Patients characteristics Admission Discharge p Value VII 0.74±0.28 0.42±0.40 0.02 LVEF (%) 43.7±17.5 42.7±16.3 0.87 TAPSE (mm) 14.9±4.1 17.1±3.6 0.14 PASP (mmHg) 51.9±15.2 39.4±11.6 0.02 TAPSE/PASP (mm/mmHg) 0.33±0.18 0.46±0.15 0.03 RI 0.8±0.1 0.7±0.1 0.11 Creatinine (mg/dL) 1.1±0.3 1.1±0.3 0.74 eGRF (mL/min/1.73 mq) 68.2±17.7 67.1±21 0.89 NT-proBNP (ng/L) 5663±5805.4 2047.2±2090.5 0.05 LVEF = left ventricular ejection fraction; BNP = natriuretic peptide; PASP = Syst art pulm press; RI = resistance index; TAPSE = tricuspid annular plane systolic excursion. Conclusions VII is a new non-invasive index that could identify renal hemodynamics alterations in HF patients. A high VII may be indicative of a congestive cardio renal syndrome in which an aggressive diuretic strategy can be set up with greater scientific evidence and the possibility of instrumental monitoring of its efficacy. Moreover, the development of drugs aimed at the improvement of the RV to PC coupling could lead to a better outcome in HF.

scholarly journals Mechanism of Persistent Ischemic Mitral Regurgitation After Annuloplasty

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Fang Zhu ◽  
Yutaka Otsuji ◽  
Goichi Yotsumoto ◽  
Toshinori Yuasa ◽  
Takayuki Ueno ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Left Ventricular Ejection ◽  
Similar Reduction ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
Posterior Displacement ◽  
Primary Determinant

Background— We hypothesized that surgical annuloplasty for ischemic mitral regurgitation (MR) that displaces the posterior annulus anteriorly can potentially augment posterior leaflet (PML) tethering, leading to persistent MR. Relationships between leaflet configurations and persistent ischemic MR after the annuloplasty were investigated. Methods and Results— In 31 patients with surgical annuloplasty for ischemic MR and 20 controls, posterior and apical displacement of the leaflet coaptation, the anterior leaflet (AML) and PML tethering angles relative to the line connecting annuli, coaptation length (CL), and the MR grade were quantified before and early after surgery in echocardiographic left ventricular long-axis views. Six of the 31 patients showed persistent MR despite annuloplasty. Compared with patients without persistent MR, those with MR showed no improvement in the left ventricular ejection fraction and systolic volume, similar reduction in the annular area, significant increase in posterior displacement of the coaptation ( P <0.01), no improvement in AML tethering, greater worsening in PML tethering ( P <0.01), and no increase in the CL. All tethering variables were significantly correlated with both preoperative and postoperative MR in univariate analysis, and reduced CL was the primary independent determinant of both preoperative and postoperative MR. Although increased AML tethering was the primary determinant of the preoperative CL (r 2 =0.46, P <0.0001), increased PML tethering was the primary determinant afterward (r 2 =0.60, P <0.0001). Conclusion— Although tethering of both leaflets is the major determinant of ischemic MR before surgical annuloplasty, both leaflets tethering but with predominant and augmented PML tethering is related to persistent ischemic MR after the annnuloplasty.

Assessment of left ventricular function and volumes by myocardial perfusion scintigraphy - comparison of two algorithms

2001 ◽  
Vol 40 (05) ◽  
pp. 135-142
Author(s):  
R. Fischer ◽  
B. Saurbier ◽  
I. Brink ◽  
E. Moser ◽  
T. Krause ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Gated Spect ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Practical Application ◽  
Cardiac Volume ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
Cardiac Models

Summary Aim: Left ventricular volume and function can be computed from gated SPECT myocardial perfusion imaging using Emory Cardiac Toolbox (ECT) or Gated SPECT Quantification (GS-Quant). The aim of this study was to compare both programs with respect to their practical application, stability and precision on heart-models as well as in clinical use. Methods: The volumes of five cardiac models were calculated by ECT and GS-Quant. 48 patients (13 female, 35 male) underwent a one day stress-rest protocol and gated SPECT. From these 96 gated SPECT images, left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ECT and GS-Quant. For 42 patients LVEF was also determined by echocardiography. Results: For the cardiac models the computed volumes showed high correlation with the model-volumes as well as high correlation between ECT and GS-Quant (r ≥ 0.99). Both programs underestimated the volume by approximately 20-30% independent of the ventricle-size. Calculating LVEF, EDV and ESV, GS-Quant and ECT correlated well to each other and to the LVEF estimated by echocardiography (r ≥ 0.86). LVEF values determined with ECT were about 10% higher than values determined with GS-Quant or echocardiography. The incorrect surfaces calculated by the automatic algorithm of GS-Quant for three examinations could not be corrected manually. 34 of the ECT studies were optimized by the operator. Conclusion: GS-Quant and ECT are two reliable programs in estimating LVEF. Both seem to underestimate the cardiac volume. In practical application GS-Quant was faster and easier to use. ECT allows the user to define the contour of the ventricle and thus is less susceptible to artifacts.

Protective effect of ghrelin against tilmicosin-induced left ventricular dysfunction in rats

2019 ◽  
Vol 97 (5) ◽  
pp. 407-412 ◽  
Author(s):  
Ebru Çetin
Keyword(s):  
Creatine Kinase ◽  
Serum Lactate ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Serum Lactate Dehydrogenase ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
Fractional Shortening

This study was conducted to investigate the possible protective effects of ghrelin against tilmicosin-induced acute ventricular dysfunction in rats. Forty adult male Sprague Dawley rats were randomly divided into 4 equal groups: control, ghrelin, tilmicosin, and ghrelin + tilmicosin. The left ventricular structural and functional parameters together with cardiac biomarker levels were evaluated. The results showed that tilmicosin treatment alone significantly decreased the left ventricular fractional shortening, left ventricular ejection fraction, left ventricular stroke volume, and cardiac output when compared with control group. In addition, tilmicosin led to a significant increase in left ventricular internal dimension in systole and left ventricular fractional end-systolic volume. At the same time, serum lactate dehydrogenase, creatine kinase, and creatine kinase-myocardial B fraction levels were significantly increased in tilmicosin-treated group when compared with control group. However, ghrelin pretreatment significantly prevented the left ventricular internal dimension in systole, left ventricular fractional end-systolic volume, left ventricular stroke volume, left ventricular ejection fraction, left ventricular fractional shortening, and cardiac output changes caused by tilmicosin. Moreover, ghrelin pretreatment could reduce significantly serum lactate dehydrogenase, creatine kinase, and creatine kinase-myocardial B fraction levels. These data indicated that ghrelin treatment may provide a protective effect against tilmicosin-induced left ventricular systolic dysfunction.

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