scholarly journals Immune-inflammatory concept of the pathogenesis of chronic heart failure in dogs with dilated cardiomyopathy

2019 ◽  
Vol 12 (9) ◽  
pp. 1491-1498 ◽  
Author(s):  
Yu Vatnikov ◽  
A. Rudenko ◽  
P. Rudenko ◽  
Ev Kulikov ◽  
A. Karamyan ◽  
...  

Background: Dilated cardiomyopathy is common in dogs. This form of cardiomyopathy is the main cause of death due to heart disease in dogs. Death can occur suddenly in clinically normal animals as a result of the progression of congestive heart failure (CHF). The pathogenesis of heart failure syndrome in dogs with dilated cardiomyopathy involves activation of the neurohumoral system and immune-mediated inflammation, which leads to further progression of the condition. Heart failure syndrome in dogs with dilated cardiomyopathy is caused by the progressive loss of cardiomyocytes, apoptosis, remodeling of the left ventricle, systolic and diastolic dysfunction, arrhythmias, reduced cerebral blood flow, the involvement of other key internal organs, and intestinal dysbiosis. Aim: This study aimed to determine the immunological and inflammatory mechanisms surrounding the development of heart failure syndrome in dogs with dilated cardiomyopathy. Materials and Methods: The subjects of this study were dogs with a dilated form of cardiomyopathy (n=159), complicated by various functional classes of heart failure syndrome. Evaluation of myocardial remodeling, systolic function, and systemic hemodynamics was performed using EMP-860 Vet and PU-2200V ultrasound scanners according to the standard technique. Electrocardiography was performed with all dogs in right lateral recumbency using the EK1T-04 Midas electrocardiograph (50 mm/s speed and 1 mV gain = 1 cm). Results: In some affected animals, especially in cases of compensated dilated cardiomyopathy, leukocytosis was noted. In patients with dilated cardiomyopathy complicated by heart failure syndrome of various functional classes, the number of neutrophils was significantly increased, and the number of lymphocytes was decreased by 1.9-2.1 times when compared with those in clinically normal animals. In dogs with dilated cardiomyopathy, neutrophilic leukocytosis develops with a simple regenerative shift to the left. The results of immunological studies indicate that dogs with dilated cardiomyopathy develop T lymphocytopenia as compared with clinically normal animals. Conclusion: The central component of heart failure syndrome in dogs with dilated cardiomyopathy is the activation of the neurohumoral system and immune-mediated inflammation. The development of CHF in dogs with dilated cardiomyopathy is caused by the progressive loss of cardiomyocytes, apoptosis, remodeling of the left ventricle, systolic and diastolic dysfunction, arrhythmias, reduced cerebral blood flow, involvement of other key internal organs, and intestinal dysbiosis.

Circulation ◽  
1995 ◽  
Vol 92 (4) ◽  
pp. 796-804 ◽  
Author(s):  
Danilo Neglia ◽  
Oberdan Parodi ◽  
Michela Gallopin ◽  
Gianmario Sambuceti ◽  
Assuero Giorgetti ◽  
...  

1994 ◽  
Vol 267 (2) ◽  
pp. H443-H448 ◽  
Author(s):  
H. Wroblewski

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.


2018 ◽  
Vol 3 (2) ◽  
pp. 12
Author(s):  
Renata Gomes Chaves ◽  
Camila Barbosa Araújo ◽  
Maria Bruna Madeiro da Silva ◽  
Natalia Jacinto de Almeida Leal ◽  
Clarissa Bentes de Araújo Magalhães ◽  
...  

A insuficiência cardíaca (IC) é uma síndrome clínica sistêmica complexa em que a disfunção cardíaca ocasiona suprimento sanguíneo inadequado para atender as necessidades metabólicas dos tecidos. Objetivou-se analisar as características funcionais pulmonares e suas repercussões em pacientes com insuficiência cardíaca de um Hospital Universitário da cidade de Fortaleza/CE. Pesquisa de campo, seccional, realizada no período de agosto de 2012 a novembro de 2013. A amostra foi composta por 20 pacientes portadores de IC (Classes II e III). Foram excluídos os pacientes que apresentaram alterações ósteomioarticulares, e os que participaram de programas de reabilitação. As avaliações consistiram em analisar as pressões inspiratórias e expiratórias máximas, o pico de fluxo expiratório e a espirometria. Na amostra pesquisada 60% (n=12) eram do sexo masculino, com média de idade de 55,3 ± 2,77 anos, 80% (n=16) eram casados, 55% (n=11) tinham como causa da IC a miocardiopatia dilatada e 40% (n=8) apresentaram fração de ejeção variando entre 36 ˫ 40%. Em relação às comorbidades apenas 30% (n=6) apresentaram diabetes, 90% (n=18) hipertensão e 40% (n=8) dislipidemia. Em relação à avaliação da musculatura respiratória, e da função pulmonar, observou-se que os valores médios foram menores significativamente quando comparados ao previsto, porém sem significância quando comparados entre as classes funcionais II e III. Houve maior prevalência de IC entre pacientes do sexo masculino, casados, em decorrência de miocardiopatia dilatada hipertensiva, com FEVE de 36 ˫ 40%. Estes pacientes tendem a reduzir à força muscular respiratória, o pico de fluxo e a função pulmonar. As classes funcionais II e III não apresentaram diferenças significativas em relação aos valores previstos em relação às variáveis analisadas. ANALYSIS OF FUNCTIONAL PULMONARY CHARACTERISTICS AND THEIR REPERCUSSIONS IN PATIENTS WITH HEART FAILURE ABSTRACT Heart failure (HF) is a complex systemic clinical syndrome in which cardiac dysfunction causes inadequate blood supply to meet the tissues' metabolic needs. The aim of this study was to analyze the pulmonary functional characteristics and their repercussions in patients with heart failure at a University Hospital in the city of Fortaleza / CE. Field research, sectional, performed from August 2012 to November 2013. The sample consisted of 20 patients with HF (Classes II and III). Patients who presented osteomioarticular alterations and those who participated in rehabilitation programs were excluded. The evaluations consisted of analyzing maximal inspiratory and expiratory pressures, peak expiratory flow, and spirometry. In the studied sample, 60% (n = 12) were males, with a mean age of 55.3 ± 2.77 years, 80% (n = 16) were married, 55% (n = 11) had as causes to CI the dilated cardiomyopathy and 40% (n = 8) had an ejection fraction ranging from 36 to 40%. Regarding comorbidities, only 30% (n = 6) presented diabetes, 90% (n = 18) hypertension and 40% (n = 8) dyslipidemia. Regarding respiratory muscle evaluation and pulmonary function, it was observed that mean values were significantly lower when compared to predicted, but without significance when compared between functional classes II and III. There was a higher prevalence of HF among male patients, married, due to hypertensive dilated cardiomyopathy, with LVEF of 36 ˫ 40%. These patients tend to reduce respiratory muscle strength, peak flow, and lung function. Functional classes II and III did not present significant differences in relation to predicted values and variables analyzed.


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