Abstract:
:Fingolimod, a sphingosine-1-phosphate receptor (S1PR) modulator, was the first oral disease-modifying therapy approved for relapsing forms of multiple sclerosis; it reduces autoreactive lymphocytes' egress from lymphoid tissues by down-regulating S1PRs. Sphingosine-1-phosphate signaling is implicated in a range of physiologic functions, and S1PRs are expressed differentially in various tissues, including the cardiovascular system. Modulation of S1PRs on cardiac cells provides an explanation for the transient effects of fingolimod on heart rate and atrioventricular conduction at initiation of fingolimod therapy, and for the mild but more persistent effects on blood pressure observed in some patients on long-term treatment. This review describes the nontherapeutic actions of fingolimod in the context of sphingosine-1-phosphate signaling in the cardiovascular system, as well as providing a summary of the associated clinical implications useful to physicians considering initiation of fingolimod therapy in patients. A transient reduction in heart rate (mean decrease of 8 beats per minute) and, less commonly, a temporary delay in atrioventricular conduction observed in some patients when initiating fingolimod therapy are both due to activation of S1PR subtype 1 on cardiac myocytes. These effects are a reflection of fingolimod first acting as a full S1PR agonist and thereafter functioning as an S1PR antagonist after down-regulation of S1PR subtype 1 at the cell surface. For most individuals, first-dose effects of fingolimod are asymptomatic, but all patients need to be monitored for at least 6 hours after the first dose, in accordance with the label recommendations.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Camm J,Hla T,Bakshi R,Brinkmann Vdoi
10.1016/j.ahj.2014.06.028subject
Has Abstractpub_date
2014-11-01 00:00:00pages
632-44issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(14)00414-1journal_volume
168pub_type
杂志文章,评审abstract::The hemodynamic effects of molsidomine were studied in 48 patients with acute myocardial infarction and compared with hemodynamic properties in a control group of 24 patients. The most pronounced decrease in pulmonary artery diastolic pressure occurs between 30 and 60 minutes after oral administration of 8 to 12 mg (n...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(85)90688-x
更新日期:1985-03-01 00:00:00
abstract::The Salt Substitute and Stroke Study is an ongoing 5-year large-scale cluster randomized trial investigating the effects of potassium-enriched salt substitute compared to usual salt on the risk of stroke. The study involves 600 villages and 20,996 individuals in rural China. Intermediate risk markers were measured in ...
journal_title:American heart journal
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更新日期:2020-03-01 00:00:00
abstract::Coronary heart disease is the single largest cause of morbidity and mortality in the United States. The link between elevated low-density lipoprotein cholesterol (LDL-C) levels and coronary heart disease (CHD) has been clearly established. However, triglycerides (TG) are increasingly believed to be independently assoc...
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pub_type: 杂志文章,评审
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abstract:BACKGROUND:Assessment of left ventricular (LV) thrombosis risk after acute myocardial infarction (AMI) is important because of potential embolic sequelae that are reduced by oral anticoagulant agents. The goal of this study was to investigate whether early assessment of LV systolic and diastolic performance with pulsed...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/j.ahj.2004.05.025
更新日期:2004-12-01 00:00:00
abstract::The effectiveness of postextrasystolic potentiation (PESP) was assessed to detect residual function of the left ventricle in seven patients with idiopathic dilated cardiomyopathy (IDC). The postextrasystolic changes in the aortic pressure pulse, global left ventricular function, and quantitative regional left ventricu...
journal_title:American heart journal
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abstract::The QRS complex and ST segment in the ECGs of 80 patients who died of an acute myocardial infarction (MI) were studied in relation to the extent of the MI (subendocardial vs. transmural). Changes in the QRS complex developed in nine out of the 15 cases with an acute subendocardial MI. Five of these cases fulfilled the...
journal_title:American heart journal
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doi:10.1016/0002-8703(79)90219-9
更新日期:1979-08-01 00:00:00
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journal_title:American heart journal
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更新日期:2014-06-01 00:00:00
abstract::The American Cancer Society's prospective study of 1 million Americans was analyzed to determine whether coronary heart disease (CHD) mortality rates by cigarette smoking in blacks differed from those in whites. More than 22,000 blacks were followed up for nearly 200,000 person-years in the 12-year study, 1960-1972. A...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90675-6
更新日期:1984-09-01 00:00:00
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journal_title:American heart journal
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更新日期:2006-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2017-05-01 00:00:00
abstract::Baroreflex modulation of forearm vascular resistance (FVR) has been reported to be abnormal in patients with congestive heart failure (CHF). However, the neurohumoral mechanisms for this impairment are not defined. We assessed the responses of arterial pressure, FVR, plasma norepinephrine, and plasma renin activity to...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90075-6
更新日期:1989-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.07.012
更新日期:2016-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1998-02-01 00:00:00
abstract::One hundred thirty-three patients with dilated heart failure, 80 with coronary artery disease, and 53 with idiopathic dilated cardiomyopathy were followed for a mean of 29 months. Patients with ischemic heart disease had a worse prognosis than those classified as having idiopathic cardiomyopathy. Features from history...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80242-x
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Female sex independently predicts bleeding risk after percutaneous coronary intervention (PCI). Bivalirudin is safer than abciximab plus heparin in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Thus, a greater benefit of bivalirudin in women would be expected. METHODS:We performed a...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.12.021
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Few studies have investigated the clinical advantages of surgical correction with the morphologic left ventricle (MLV) instead of the morphologic right ventricle as a systemic ventricle (SV) in patients with congenital heart disease. METHODS:Twenty-four healthy control subjects (group A1), 6 patients with i...
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pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70381-9
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Previous research suggests that after coronary artery bypass graft (CABG) surgery, women fare worse than men. This study investigates sex differences in depression during recovery from CABG surgery. METHODS:We followed 137 patients (72 men, 65 women) undergoing elective isolated first CABG surgery between J...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.05.005
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:We aim to validate the diagnostic performance of the first fully automatic, electronic heart failure (HF) identification algorithm and evaluate the implementation of an HF Dashboard system with 2 components: real-time identification of decompensated HF admissions and accurate characterization of disease char...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.10.001
更新日期:2017-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究
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更新日期:2011-02-01 00:00:00
abstract::Inhibition of the enzyme that synthesizes thromboxanes may protect against the development of ventricular fibrillation (VF) during acute myocardial ischemia. This study was carried out to test this hypothesis with a new thromboxane synthetase inhibitor, and to extend the studies to alternative animal models of myocard...
journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1989-04-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1999-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90868-5
更新日期:1989-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80086-9
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The same electrocardiographic (ECG) criteria that have been used for detection of left ventricular hypertrophy (LVH) have recently been recognized as predictors of adverse clinical outcomes, but this predictive ability is inadequately explored and understood. METHODS:A total of 14,984 participants from the ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2015.04.004
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Protease inhibitors (PIs) may be associated with accelerated atherosclerosis in individuals infected with human immunodeficiency virus (HIV). We assessed the effects of HIV PIs on subclinical atherosclerosis. METHODS:The lipid profiles, C-reactive protein (CRP) levels, coronary artery calcification (CAC) sc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125009
更新日期:2002-10-01 00:00:00
abstract::Intracoronary streptokinase (SK) was administered to 11 patients with evolving acute transmural myocardial infarction 5.5 +/- 0.4 hours from the onset of symptoms. Ten patients (91%) had total coronary occlusion, and one had subocclusion of the vessel corresponding to the ECG site of infarction. Intracoronary nitrogly...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90646-3
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:Previous studies reported an impairment of nervous autonomic activity in patients with Duchenne muscular dystrophy (DMD). However, the relationship of the autonomic dysfunction to the impairment of cardiac mechanical function and of respiratory failure is not completely understood. METHODS:We evaluated card...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.114804
更新日期:2001-05-01 00:00:00
abstract::The aim of this study was to determine whether paroxysmal atrial fibrillation (PAF) and/or restoration to sinus rhythm with electric or pharmacologic cardioversion induce modifications to the coagulation system. Thirty-five patients with PAF undergoing either electric (n = 11) or pharmacologic (n = 24) cardioversion w...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.108520
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:The long-term effects of smoking and smoking cessation on markers of cardiovascular disease (CVD) prognosis obtained during treadmill stress testing (TST) are unknown. The purpose of this study was to evaluate the long-term effects of smoking cessation and continued smoking on TST parameters that predict CVD...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2011.06.023
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Intracranial hemorrhage is an uncommon but very dangerous complication in patients receiving thrombolytic therapy for acute myocardial infarction. Neurosurgical evacuation is often an available treatment option. However, the association between neurosurgical evacuation and clinical outcomes in these patients...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(99)70152-3
更新日期:1999-09-01 00:00:00