Beta-Blockers and Oxidative Stress in Patients with Heart Failure

Increased sympathetic activation and oxidative stress/pro-inflammatory status cause lymphocytopenia by activating programmed lymphocyte death in patients with HF. Moreover, a low lymphocyte count correlates with reduced haemodynamics and aerobic capacity, which reflects poor generic/disease-specific QoL in the HF patients.

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Clinical Experience with Ivabradine in Acute Heart Failure

Cardiology ◽

10.1159/000444845 ◽

2016 ◽

Vol 134 (3) ◽

pp. 372-374 ◽

Cited By ~ 10

Author(s):

Marina Pascual Izco ◽

Gonzalo Luis Alonso Salinas ◽

Marcelo Sanmartín Fernández ◽

Hugo Del Castillo Carnevalli ◽

Manuel Jiménez Mena ◽

...

Keyword(s):

Oxidative Stress ◽

Heart Failure ◽

Blood Pressure ◽

Randomized Trials ◽

Beta Blockers ◽

Treatment Results ◽

Absolute Reduction ◽

Attractive Option ◽

And Oxidative Stress

Objective: Ivabradine has been shown to improve symptoms and to reduce rehospitalization and mortality in patients with severe chronic heart failure (HF). Its indication in acute HF is not clear. Acute HF patients could also benefit from HR reduction, as myocardial consumption and oxidative stress are related to tachycardia. Moreover, beta-blockers are contraindicated in cardiogenic shock and should not be initiated with congestive signs. Accordingly, we evaluated the role of ivabradine in acute HF patients. Methods: This was a retrospective analysis of 29 consecutive patients treated for acute HF in the Cardiac ICU, and for whom ivabradine was initiated during hospitalization between January 2011 and January 2014. All patients were in sinus rhythm and had a heart rate (HR) >70 bpm. Catecholamine use was necessary in 16 patients (57.1%) during the hospitalization, in 14 (87.5%) of these before ivabradine treatment. Results: Systolic blood pressure showed no variation during the first 24 h of ivabradine administration or at discharge. HR showed an absolute reduction of 10 bpm at 6 h (p < 0.001), 11 bpm at 24 h (p = 0.004) and 19 bpm (p < 0.001) at discharge. No episodes of significant bradycardia or hypotension were recorded after starting the drug. Conclusions: HR reduction with ivabradine in acute HF is well tolerated. It represents an attractive option, especially when there is excessive catecholamine-related tachycardia; this should be appropriately evaluated in randomized trials.

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Intensity and duration of exercise on inflammatory markers and oxidative stress in patients with heart failure

10.1183/13993003.congress-2015.pa4819 ◽

2015 ◽

Author(s):

Giane Ribeiro-Samora ◽

Mariana Hoffman Barbosa ◽

Luiza Antas Rabelo ◽

Glaucevane Silva Guedes ◽

Michelle Favero ◽

...

Keyword(s):

Oxidative Stress ◽

Heart Failure ◽

Inflammatory Markers ◽

Patients With Heart Failure ◽

And Oxidative Stress

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Changes in Cardiopulmonary Reserve and Peripheral Arterial Function Concomitantly with Subclinical Inflammation and Oxidative Stress in Patients with Heart Failure with Preserved Ejection Fraction

International Journal of Vascular Medicine ◽

10.1155/2014/917271 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Damien Vitiello ◽

François Harel ◽

Rhian M. Touyz ◽

Martin G. Sirois ◽

Joel Lavoie ◽

...

Keyword(s):

Oxidative Stress ◽

Heart Failure ◽

Blood Flow ◽

Ejection Fraction ◽

Arterial Blood Flow ◽

Preserved Ejection Fraction ◽

Arterial Blood ◽

Patients With Heart Failure ◽

Peripheral Arterial ◽

And Oxidative Stress

Background. Changes in cardiopulmonary reserve and biomarkers related to wall stress, inflammation, and oxidative stress concomitantly with the evaluation of peripheral arterial blood flow have not been investigated in patients with heart failure with preserved ejection fraction (HFpEF) compared with healthy subjects (CTL).Methods and Results. Eighteen HFpEF patients and 14 CTL were recruited. Plasma levels of inflammatory and oxidative stress biomarkers were measured at rest. Brain natriuretic peptide (BNP) was measured at rest and peak exercise. Cardiopulmonary reserve was assessed using an exercise protocol with gas exchange analyses. Peripheral arterial blood flow was determined by strain gauge plethysmography. Peak VO2(12.0±0.4versus19.1±1.1 mL/min/kg,P<0.001) and oxygen uptake efficiency slope (1.55±0.12versus2.06±0.14,P<0.05) were significantly decreased in HFpEF patients compared with CTL. BNP at rest and following stress, C-reactive-protein, interleukin-6, and TBARS were significantly elevated in HFpEF. Both basal and posthyperemic arterial blood flow were not significantly different between the HFpEF patients and CTL.Conclusions. HFpEF exhibits a severe reduction in cardiopulmonary reserve and oxygen uptake efficiency concomitantly with an elevation in a broad spectrum of biomarkers confirming an inflammatory and prooxidative status in patients with HFpEF.

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