MVD may be a safe and effective strategy for HFS patients in view of relatively higher cure rates and lower complication risks within follow-up. Besides, patients' age, duration of disease, intraoperative indentation of the REZ of the facial nerve, and disappearance of AMR were the major influential variables may be useful for the prediction of prognosis in the patients underwent MVD.
Aims
A meta‐analysis was performed to compare the therapeutic outcomes in patients treated for heart failure (HF) with recombinant human brain natriuretic peptide (rhBNP) and dobutamine.
Methods
PubMed, Embase and the Chinese Biomedical Database were exhaustively searched to identify studies relevant to this meta‐analysis. Eight cohort studies were found suitable for inclusion. Data regarding trial validity, methodological processes and clinical outcomes were extracted.
Results
Patients treated with rhBNP showed statistically significant reduction of in‐hospital mortality and re‐admission rates compared with the dobutamine treated patient group (both P < 0.05). Further, the rhBNP treated patient group showed higher survival outcomes, compared with dobutamine treated patients, when the post‐treatment follow‐up period was longer than 6 months (P < 0.05). Stratified analysis based on ethnicity showed a dramatic decrease of in‐hospital mortality among mixed race HF patients receiving rhBNP treatment (P < 0.05), but such decreases were not statistically significant in Asian and Caucasian populations (both P > 0.05). On the other hand, re‐admission rates were significantly lower in rhBNP treated Caucasian and mixed race populations (both P < 0.05). Notably, in rhBNP treated group, dose levels of 0.015 and 0.03 incrementally lowered the re‐admission rates, displaying dose effect, and the re‐admission rates at both rhBNP doses were significantly lower than the dobutamine treated group (both P < 0.05).
Conclusions
Our meta‐analysis results suggested that rhBNP therapy is associated with lower in‐hospital mortality and re‐admission rates in HF patients compared to the dobutamine regimen. Nevertheless, large scale prospective, randomized trials are necessary to confirm these findings.
Objective Sepsis is a systemic and deleterious host reaction to severe infection. Cardiac dysfunction is an established serious outcome of multiorgan failure associated with this condition. Therefore, it is important to develop drugs targeting sepsis-induced cardiac damage and inflammation. Thymoquinone (TQ) has anti-inflammatory, anti-oxidant, anti-fibrotic, anti-tumor, and anti-apoptotic effects. This study examined the effects of thymoquinone on sepsis-induced cardiac damage. Methods Male BALB/c mice were randomly segregated into four groups: control, TQ, cecal ligation and puncture (CLP), and CLP + TQ groups. CLP was performed after gavaging the mice with TQ for 2 weeks. After 48 hours, we estimated the histopathological changes in the cardiac tissue and the serum levels of cardiac troponin-T. We evaluated the expression of factors associated with inflammation, apoptosis, oxidative stress, and the PI3K/AKT pathway. Results TQ significantly reduced intestinal histological alterations and inhibited the upregulation of interleukin-6, tumor necrosis factor-α, Bax, NOX4, p-PI3K, and p-AKT. TQ also increased Bcl-2, HO-1, and NRF2 expression. Conclusion These results suggest that TQ effectively modulates pro-inflammatory, apoptotic, oxidative stress, and PI3K/AKT pathways, making it indispensable in the treatment of sepsis-induced cardiac damage.
Cardiac dysfunction can be a fatal consequence of sepsis and lead to increased inflammatory responses or reduced fatty acid oxidation and final ATP depletion. Fenofibrate, which is an agonist of peroxisome proliferator-activated receptor α, has been used primarily in hypercholesterolemia and mixed dyslipidemia. Recent studies found that fenofibrate could alleviate energy metabolism and inflammation caused by cardiac damage during sepsis, and thus it had been paid great attention. This study was to investigate the possible protective roles of fenofibrate against cardiac damage in septic BALB/c mice. Methods: Forty male BALB/c mice aged 8 weeks old were divided randomly into four groups: control group; fenofibrate group; cecal ligation and puncture (CLP) group; and fenofibrate + CLP group. After administering fenofibrate or saline for 2 weeks, CLP was performed. Cardiac tissue and plasma were obtained 48 hours later. Plasma Troponin-T (Tnt), ATP, ADP and reactive oxygen species (ROS) levels were determined. PPARα and 53 protein levels were detected using western blotting. IL-6 and tumor necrosis factor-α (TNFα) were also assayed. We found that fenofibrate decreased plasma cTnT, ROS and increased the ratio of ATP/ADP. The elevations of IL-6, TNFα and P53 induced by sepsis were significantly suppressed by fenofibrate. Our results suggest that fenofibrate can regulate energy metabolism efficiently, which makes it a possible agent for treating sepsis-induced cardiac damage.
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