Abstract:
AIMS:The cardio-renal syndrome plays a critical role in acute heart failure (HF). Levosimendan, an inodilator drug, has a positive but controversial effect on kidney. Our aim was to evaluate its effects on both renal and systemic haemodynamic parameters as well as on renal function, explaining the possible mechanisms involved. METHODS AND RESULTS:Patients with acute decompensated HF, moderate renal impairment, wedge pressure >20 mmHg and EF <40% were eligible. Twenty-one patients were randomized to infusion of levosimendan or placebo, on top of standard therapy. Systemic haemodynamic parameters (wedge and cardiac output) were evaluated at baseline and at 8, 16, 24, 48, and 72 h. An intravascular renal artery Doppler exam was performed at baseline, after levosimendan bolus, and 1 h thereafter. Renal blood flow, glomerular filtration rate (GFR), cystatin C, blood urea nitrogen (BUN), urinary output, sodium excretion, and plasma sodium were measured. The effect of levosimendan was beneficial and significantly different from placebo on several renal and cardiac parameters. Specifically, the levosimendan and placebo group exhibited significantly different changes over time in GFR (P = 0.037), renal blood flow (P = 0.037), and renal artery diameter (P = 0.033), with ensuing improvements in serum levels of BUN (P = 0.014), creatinine (P = 0.042), and cystatin C (P = 0.05). Concomitantly, levosimendan provided a significant increase in urine output up to 72 h (P = 0.02). These beneficial results on renal parameters were accompanied by similarly significant and favourable changes in cardiac index (P = 0.029) and PCWP (P < 0.001). CONCLUSION:Levosimendan, in acute decompensated HF, has an immediate renoprotective effect, mediated by an increase in renal blood flow, due to a selective renal arterial and venous vasodilating action. TRIAL REGISTRATION:NCT00527059.
journal_name
Eur J Heart Failjournal_title
European journal of heart failureauthors
Fedele F,Bruno N,Brasolin B,Caira C,D'Ambrosi A,Mancone Mdoi
10.1002/ejhf.9subject
Has Abstractpub_date
2014-03-01 00:00:00pages
281-8issue
3eissn
1388-9842issn
1879-0844journal_volume
16pub_type
杂志文章,随机对照试验abstract:AIMS:To investigate the relationship between central venous pressure (CVP) at presentation to the emergency room (ER) and the risk of cardiac rehospitalization and mortality in patients with decompensated heart failure (DHF). METHODS AND RESULTS:Central venous pressure was determined non-invasively using high-resoluti...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfq024
更新日期:2010-05-01 00:00:00
abstract:AIMS:As periprocedural risk is low, MitraClip implantation is often performed in critically ill, not fully recompensated patients, who are in NYHA functional class IV at the time of the procedure, to accelerate convalescence. We herein sought to evaluate the procedural and 30-day outcome of this patient group. METHODS...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1002/ejhf.169
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND AND AIMS:The diagnosis of heart failure is an important clinical problem and yet reported diagnostic accuracy in primary care is less than 50%. We established a Rapid Access Heart Failure Clinic (RAHFC) in a district general hospital serving a population of 292,000 in SE London, UK, to diagnose and manage ne...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(00)00108-2
更新日期:2000-12-01 00:00:00
abstract::It is well known that atrial fibrillation can lead to heart failure, and is attributed to rapid ventricular rate (tachycardia-induced cardiomyopathy). Some recent studies suggest the possible existence of an intrinsic left-ventricular factor related to atrial fibrillation, irrespective of other elements. In order to d...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(02)00004-1
更新日期:2002-06-01 00:00:00
abstract:AIMS:To assess the tolerability of initiating/uptitrating sacubitril/valsartan (LCZ696) from 50 to 200 mg twice daily (target dose) over 3 and 6 weeks in heart failure (HF) patients (ejection fraction ≤35%). METHODS AND RESULTS:A 5-day open-label run-in (sacubitril/valsartan 50 mg twice daily) preceded an 11-week, dou...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1002/ejhf.548
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Although discontinuation of chronic ACE inhibitor (ACEi) therapy after myocardial infarction (MI) is common in clinical practice, some clinical studies reported an increased incidence of ischemia-related events after withdrawal. To further address this issue, we assessed hemodynamic, neurohormonal and vascul...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2005.04.014
更新日期:2006-03-01 00:00:00
abstract:AIMS:To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction. METHODS:3166 consecutive patients screened for entry in the Bucindolol Evaluation in Acute Myoc...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(03)00159-4
更新日期:2003-12-01 00:00:00
abstract::Patients with heart failure (HF) are at an increased risk of stroke, sudden death and venous thromboembolism, which are all linked to thrombus formation (thrombogenesis). The present 'viewpoint' article will discuss how the prothrombotic state in HF may be perpetuated by a chronic inflammatory state that is maladaptiv...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1016/j.ejheart.2006.05.009
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:The rate constant for global fatty acid influx (k(1)) was studied in 12 male patients with dilated cardiomyopathy (DCM). METHOD:10 normal subjects served as controls. 201-Thallium (201TI) and [123I]-phenyl-pentadecanoic acid (IPPA) were administered during bicycle exercise under fasting conditions. RESULTS...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(02)00024-7
更新日期:2002-08-01 00:00:00
abstract::The use of erythropoietin (EPO) has revolutionized the treatment of anaemia associated with many conditions including chronic kidney disease (CKD). However, little is known of the cellular impact of EPO on the uraemic heart. The discovery that the EPO receptor (EPOR) is also expressed on non-haematopoietic cells inclu...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1093/eurjhf/hfp093
更新日期:2009-08-01 00:00:00
abstract:AIMS:Exercise-derived parameters, specifically peak exercise oxygen uptake (peak VO2 ) and minute ventilation/carbon dioxide relationship slope (VE/VCO2 slope), have a pivotal prognostic value in heart failure (HF). It is unknown how the prognostic threshold of peak VO2 and VE/VCO2 slope has changed over the last 20 ye...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1002/ejhf.1364
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:It has been suggested that oxidative stress may play a role in the pathogenesis of heart failure, this may have potential implications for therapeutic strategies. However, measures of oxidative stress are subject to confounding inaccuracies. IgG antibodies to oxidized LDL reflect exposure to the lipoprotein ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2005.04.015
更新日期:2006-01-01 00:00:00
abstract::Self-care is essential in the long-term management of chronic heart failure. Heart failure guidelines stress the importance of patient education on treatment adherence, lifestyle changes, symptom monitoring and adequate response to possible deterioration. Self-care is related to medical and person-centred outcomes in ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.2008
更新日期:2020-09-18 00:00:00
abstract:BACKGROUND:Mortality in patients with mild to moderate chronic heart failure remains high. At present there is no easy way of identifying patients within this population at increased risk of death in the medium to long term. AIMS:To develop a prognostic index to identify outpatients with mild to moderate chronic heart...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(03)00053-9
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Plasma concentrations of atrial natriuretic peptides are correlated with atrial pressures, as are left ventricular ejection fraction and left ventricular filling abnormalities. AIMS:This study investigated the relation of atrial natriuretic peptides to both left ventricular systolic and diastolic function i...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(98)00005-1
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Patients with chronic heart failure (CHF) have frequent episodes of exacerbation leading to recurrent hospitalization. AIMS:To explore factors related to patients seeking care for worsening CHF. METHODS:Eighty-eight patients diagnosed with a deteriorating CHF condition were interviewed. Data were analysed ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2006.11.002
更新日期:2007-06-01 00:00:00
abstract:AIMS:The most recent European guidelines have proposed new definitions of pulmonary hypertension (PH) in left heart disease, to better approach the characteristics required to reflect the presence of pulmonary vascular disease. The purpose of this study was to assess whether different haemodynamic definitions of post-c...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1067
更新日期:2018-04-01 00:00:00
abstract:AIM:Evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) to confirm or disprove heart failure in community patients complaining of dyspnoea. METHODS AND RESULTS:General practitioners referred 345 consecutive patients complaining of dyspnoea to our hospital-based clinic, where a diagnosis was established ...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/j.ejheart.2003.10.003
更新日期:2004-01-01 00:00:00
abstract:AIMS:Galectin-3 is a prognostic heart failure (HF) biomarker that may mediate cardiac fibrosis. We examined the value of serial galectin-3 measurement for prognosis and response to therapy in chronic HF. METHODS AND RESULTS:A total of 151 subjects with LV systolic dysfunction (LVSD) were followed through 908 visits ov...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hft075
更新日期:2013-10-01 00:00:00
abstract:AIMS:It is unclear whether myocardial velocity or deformation indices of dyssynchrony are better at predicting response to cardiac resynchronization therapy (CRT). Therefore, two indices of left ventricular (LV) dyssynchrony based on myocardial velocity and deformation were compared to predict success of CRT. METHODS ...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1093/eurjhf/hfp032
更新日期:2009-04-01 00:00:00
abstract::Appropriate interpretation of changes in markers of kidney function is essential during the treatment of acute and chronic heart failure. Historically, kidney function was primarily assessed by serum creatinine and the calculation of estimated glomerular filtration rate. An increase in serum creatinine, also termed wo...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1697
更新日期:2020-04-01 00:00:00
abstract:AIMS:Clinical presentation of takotsubo syndrome (TTS) mimics acute coronary syndrome (ACS) and does not allow differentiation. We aimed to develop a clinical score to estimate the probability of TTS and to distinguish TTS from ACS in the acute stage. METHODS AND RESULTS:Patients with TTS were recruited from the Inter...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1002/ejhf.683
更新日期:2017-08-01 00:00:00
abstract:AIMS:The 'Hospital at home' (HaH) model avoids hospital admission by transferring healthcare and treatment to the patient's home. We aimed to compare the effectiveness and direct healthcare costs of treating elderly patients with decompensated heart failure (HF) using HaH care vs. inpatient hospital care (IHC) in a car...
journal_title:European journal of heart failure
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurjhf/hfp143
更新日期:2009-12-01 00:00:00
abstract::This article updates the Heart Failure Association of the European Society of Cardiology (ESC) 2007 classification of advanced heart failure and describes new diagnostic and treatment options for these patients. Recognizing the patient with advanced heart failure is critical to facilitate timely referral to advanced h...
journal_title:European journal of heart failure
pub_type: 杂志文章,评审
doi:10.1002/ejhf.1236
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and ...
journal_title:European journal of heart failure
pub_type: 临床试验,杂志文章
doi:10.1016/j.ejheart.2007.06.001
更新日期:2007-09-01 00:00:00
abstract:AIMS:Recent studies have shown that microRNAs (miRNAs), besides being potent regulators of gene expression, can additionally serve as circulating biomarkers of disease. The aim of this study is to determine if plasma miRNAs can be used as indicators of disease progression or therapeutic efficacy in hypertension-induced...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hft018
更新日期:2013-06-01 00:00:00
abstract:AIMS:To examine the impact of diabetes mellitus on long-term clinical outcomes in patients with myocardial infarction (MI) complicated by clinical signs of heart failure (HF) or left ventricular dysfunction (LVD). METHODS AND RESULTS:The High-Risk MI Database consists of individual data from 28 771 patients and was cr...
journal_title:European journal of heart failure
pub_type: 杂志文章,多中心研究
doi:10.1002/ejhf.797
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Platelet-endothelial interactions modulated by adhesion molecules, may play an important role in the pathogenesis of congestive heart failure (CHF). Soluble levels of these molecules and platelet-derived substances are reportedly elevated in patients with CHF. However, no data are available on the plasma lev...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1016/s1388-9842(99)00029-x
更新日期:1999-08-01 00:00:00
abstract:AIMS:Women with heart failure (HF) are under-represented in individual randomized clinical trials (RCTs). Little is known about sex-specific treatment effects in HF medications. We evaluated sex differences in the response to mineralocorticoid receptor antagonists (MRAs) in major HF MRA trials, including a broad spectr...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1002/ejhf.1740
更新日期:2020-05-01 00:00:00
abstract:UNLABELLED:Aim Frequent ventricular premature contractions (VPCs) may cause haemodynamic deterioration and reversible left ventricular (LV) dysfunction. We aimed to clarify this mechanism. METHODS AND RESULTS:The haemodynamics, echocardiographic parameters, and plasma brain natriuretic peptide (BNP) level were assesse...
journal_title:European journal of heart failure
pub_type: 杂志文章
doi:10.1093/eurjhf/hfs095
更新日期:2012-10-01 00:00:00